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A I <br /> US411fSTEM RETROFIT OR REPAIR (ig % Z017 <br /> (Sub��,Iti,MlpuMq 3 sets of plans&applications as originals will be retained by EHD) <br /> 1. Site map enclosed? YES Pq NO <br /> -r- E "'! Hr: &1 <br /> NViR0N1A'-"JT <br /> -AH <br /> 2. Submit Mi and/or Installer's certificate and all manufacturer trainingr rt ' as for e <br /> lnstach <br /> ,=Igo <br /> n <br /> person aJ1lngv9"0**q one ant 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. H repairing a component,describe how this will be done. (If <br /> Adft piping, UDC's,or other LIST equipment, or performing tank top upgrade, use the LIST Installation Application <br /> pages 4-8 as necessary for a timely plan review): <br /> R2place all(6)existing dispensers, change tank 3 unleaded to diesel,trench,install piping from tank 3 <br /> to the front(3)disoensers UDCs with Smith Fftto pj2jng,__-AL0 <br /> Te:1 <br /> S <br /> -AAA C- <br /> QLaala-'' OAgi% it 0 A <br /> CIL t2 &Q 1P L I.. I L L( <br /> '2 <br /> x—x-6-7- CA UeA <br /> MPA 4e,2- <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> Smith 3"fib olass red thread pipe and associated elbows and couplings <br /> -Smith 41"ber lass red thread seconSLa=iping with associated elbows.couplings, and termination fittings <br /> A- <br /> IY7 A- <br /> kl-q4j- (0a) 11A q9/00 <br /> A'Is <br /> 3 <br />