Laserfiche WebLink
I � <br /> i <br /> I <br /> I <br /> SANJ O A Q U I N Environmental Health Department <br /> COUNTY — - a <br /> UST SYSTEM RETROFIT OR REPAIR AP ;� �" 2020 <br /> ( Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br /> 1 . Site map enclosed ? YES [ ] NO [ ] ENVIRON r N !a} faLp `iEALTH <br /> 3 it it IT 2 . Submit copies of ICC Service Technician and/or Installer' s certificate and all manufacturer training <br /> certificates for each person installing or testing any component that is repaired or replaced . Ensure a copy of <br /> the " Site Health and Safety Plan " is available on the jobsite as required by Title 8 . <br /> 3 . Detailed description of work to be completed . List components to be repaired or replaced and attach a <br /> diagram drawn to scale showing location of repairs and/or replacements . If repairing a component, describe <br /> how this will be done . ( If adding piping , UDC 's , or other UST equipment , or performing tank top upgrade , <br /> use the UST Installation Application pages 4-8 as necessary for a timely plan review) : <br /> Remove and replace 2 dispensers <br /> Install Bravo conversion frames <br /> 4 . List of equipment to be used (Attach manufacturer' s specification sheets showing third-party approval) : <br /> i <br /> 2 CONV-B2000 Bravo Conversion Frames j <br /> I <br /> 2 Wayne Ovations <br /> 1 <br /> 5 . Decontamination Procedures : <br /> a . Will piping be decontaminated prior to removal? YES [ ] NO [ ] <br /> b . Identify contractor performing decontamination : <br /> Name Phone �) <br /> Address City Zip <br /> 3of6 <br /> I <br /> I <br /> f <br />