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Apr 02 12 11:51a Reliable Petroleurr209-845-8953 p.5 <br />2. <br />(Submit <br />Site map enclosed? <br />Submit capias of ICC <br />Jerson installing or to <br />Plan" is available on tI <br />Detailed description <br />to scale showing loca <br />addin piping, UDC°s <br />pages 4-8 as necesse <br />UST SYSTEM RETROFIT OR REPAIR <br />minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />YES K NO <br />ervics Technnician and/or Installer's certificate and all manufacturer training certificates for e <br />ting any component that is repaired or replaced. Ensure a copy of the "Site Health and Sa <br />e jobsite as required by Title 8. <br />wofk to be completed. List components to be repaired or replaced and attach a diagram dr <br />'on of repairs and/or replacements. If repairing a component, describe how this will be done <br />rforming tank top upgrade, use the UST Installation ApplicE <br />or other UST equipment, or pe <br />ry for a timejy plan review): <br />e <br />List of equipment to <br />Nf 122v <br />a used (Attach manufacturer's soeafication sheets showing third -party approval): <br />-r P�.2— :Sof � 5 ..1.,U y. VCS i U ri <br />ach <br />fety <br />awn <br />(If <br />tion <br />