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12/17/2012 15:23 9163731173 WALTONENGINEERING PAGE 02/11 <br /> UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 3 sets of plans&applications as originals Will be retained by 51-11)) <br /> i Site map enclosed? YES 14 NO 11 <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 /> aa 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 /> Fag.Luty was B w' a corn at' alar warm t <br /> 7.achnic.an fgi;nd vnitaga, rci rp2d <br /> start the-- -Inzon-t- And install a new hACk-=._bg gry on the, QRU,__ <br /> 4. List of equipment to be used(Attach manufacturers specification sheets showing third-party approval): <br /> 3 <br />