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Ali <br /> UST SYSTEM RETROFIT OR REPAIR SIV 2 p 2017 <br /> (Submit minimum of 3 sets of plans&applications as originals will be retained by EHD) <br /> 1. Site map enclosed? YES P9 NO [] C,� <br /> 2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training°certificates foieach <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 locatio of repairs and/or replacements. If repairing a component,,lescribe how this will be done. (If <br /> adding piping, UDC's, or her UST equipment, or performing tank top upgrade,,u"se the UST Installation Application <br /> pages 4-8 as necessary fortimely plan review): <br /> Replace all (6 exist ng dis a sers, change tank 3 unleaded to diesel, t4rich, install piping from tank 3 <br /> to the front 3 dis erisers UDC' with Smith Fiberglass pipina. <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval): <br /> Smith 3"fiberglass red thread pipe and associated elbows and couplings. <br /> Smith 4"fiberglass re "thread secondary pipingwith associated elbows, cou lin s and termination fittings <br /> 3 <br />