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10/08/2010 14:50 2097959551 <br />SEXTON t�PAGE 01 <br />1, 11 ► . "" •(t . <br />LIST SYSTEM RETROFIT OR <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />1. Site map enclosed? YES [I [ <br />Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates for <br />each person installing or testing any component that is repaired or replaced. Ensure a copy of the "Site Health <br />and Safety Plan" Is available on the jobsits 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 <br />drawn to scale showing location of repairs and/or replacements. If repairing a component, describe how this will <br />be done. (If adding piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST <br />Installation Application pages 4-8 as necessary for a timely plan review): <br />L <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -parry approval), <br />111 0 <br />3 <br />