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E <br />11 <br />UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EMD) <br />4. Site map enclosed? YES W NO [ I <br />2. Submit copies of ICC Service Technician and/or Installers certificate and all manufacturer training certificates for each <br />person Installing or testing any component that is repaired or replaced. Ensure a copy of the "Site Health and Safety <br />Plan" is available on the jobsite as required by Title 8. <br />Detailed description of work to be completed. List components to be repaired or replaced and attach a diagram drawn <br />to scale showing location of repairs and/or replacements. If repairing a component, describe how this will be done. (If <br />Aging piping, UDCs, or other LIST equipment, or performing tank top upgrade, use the LIST Installation Application <br />pages 4-8 as necessary for a timely plan review): <br />--vu& Sso <br />Ust of equipment to be used (Attach manufacturer's` <br />sheets showing third -party approvao: <br />Si (do I a S 4T- <br />/tz i <br />AV 13 2014 <br />ENVIROiwo&,�-raj <br />