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Feb 17 12 08:15a Reliable Petrole 45-8953 p.5 <br />(Sub <br />Site map enclosed? <br />Submit copies of IM <br />person installing or <br />Plan" is available or <br />Detailed description <br />to scale showing location <br />adding piping, UDC <br />pages 4-8 as necessary <br />ledm-eclt <br />UST SYSTEM RETROFIT OR REPAIR <br />it minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />YES (] NO <br />Service Technician and/or Installer's certificate and all manufacturer training certificates fo <br />esting any component that is repaired or replaced. Ensure a copy of the "Site Health and <br />the jobsite as required by Title 8. <br />of work to be completed. List components to be repaired or replaced and attach a diagram <br />of repairs and/or replacements, If repairing a component, describe how this will be dor <br />s, or other UST equipment, or performing tank top upgrade, use the UST Installation Appli <br />for a timely plan review): <br />S ,rp_0SU <br />\Lee er <br />f- <S Or s c. 3 - <br />List of equipment to be <br />used (Attach manufacturer's specification sheets showing third -party approval): <br />Ll 3 F o - ? <br />s <br />each <br />Safety <br />Drawn <br />ie. (If <br />ration <br />