Laserfiche WebLink
IMMM40 YES[] NO$., <br />Submitc 0' les ' ICC Service Technician and/or Installer's certificate and all manufacturer training certificates for each <br />person installin or testing any component that is repaired or replaced. Ensure a copy of the Site Health and Safety <br />Plan" is availabl on the jobsite as required by Title 8, <br />M9- ttion of work to be completed. List components to be repaired or replaced and attach a diagram drawn <br />location of repairs and/or replacements. If repairing a component, describe how this will be done. (if <br />oil 8 0 0 !JDC's, or other LIST equipment or performing tank top upgrade, use the UST Installation Application <br />I <br />0 -oz , : cessary for a timely plan review): <br />-z <br />24 ',-OURS 3AS <br />190! S EL OORADT: <br />S'�OXMTt N CA <br />12/22/2016 1-2.429 ?M <br />SUMP LEAX <br />'j - DC 3_j <br />71S7 STARTiED " 2' -,, I P�l <br />7EST S7AR7D 112/22/2016 <br />BEG"Irk LE'VE. <br />6.a24'' 1 <br />END 7pir <br />12129 PIKI <br />Ef�'D DATE <br />1:2/22/20' '6 <br />;7ND !_ZUE" <br />6.5245 -IN <br />EAK THRFSHO'6�, <br />0.002 air <br />TEST RESULT <br />DASSED <br />List of equipme6t to be used (Attach manufacturer's specification sheets showing third -party approval): <br />M <br />