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UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 3 sets of plans&applications as originals will be retained by EHD) <br /> 1. Site map enclosed? YES V NO[] <br /> 2. Submit copies of ICC Service Technician and/or Installer's 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 /> 3. 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 /> adding piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST Installation Application <br /> pages 4-8 as necessary for a timely plan review): <br /> REPLACE(4)OVATION DRESSER WAYNE DISPENSERS WITH(4)NEW OVATION-2 DISPENSERS AND VST HANGING HARDWARE. <br /> CONVERT HEALY ASSIST SYSTEM VR-202 TO BALANCE SYSTEM VR-204 <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> DRESSER WAYNE OVATION TWO B-12 DISPENSERS(3+0) <br /> DRESSER WAYNE OVATION TWO B-23 DISPENSERS(3+1) <br /> VST EVR HOSE WITH VENTURI <br /> VST G2 BALANCE EVR NOZZLES WITH SRM,BLACK <br /> HUSKY PRESSURE-ACTIVATED DIESEL NOZZLE,GREEN <br /> VST REATTACHABLE BALANCE BREAKWAY <br /> VST VST EVER BALANCE WHIP HOSE <br /> OPW MULTI-PLANE SWIVEL <br /> VEEDER-ROOT SOFTWARE UPGRADE KIT <br /> 2 <br />