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tia3 2,7 11 11 : 24a Elite V Contactors 120946 342 a P. 1 <br /> a _ 4 <br /> �1�5�rr c'�tnl y -' 1 3�i _443 <br /> { UST SYSTEM RETR®Frr OR RER ,FR <br /> (Submit minimum of 3 sets of plans&applications as originals wi'! E4 retained by EHD a-- <br /> I. Site map enclosed? YES I1 NO.[] <br /> s 2. Submit r, <br /> copies of ICC Service.Technician andlor lnstalter's certificate and all n anufactUrer training r far <br /> each person installing or iesfrng any component that is repaired or reptacm. Ensure a copy of the"Site'Ffealth <br /> and afefy Plan"is available on the jobsite as required by.Title a. <br /> 3. Detailed description of work to be completed_ list components to be <br /> drawn to scab showing locafion'of repairs and/or replacements. if inn repaired ;r replaced.and �a diagram <br /> be done. (if a_ d ft pi � ng a *mPonenf, describe how this will <br /> Installation kation �. Ups' or other UST equipment, or perfbrmfrrg tank top upgrade, use the UST <br /> �p pages 4-$as necessary for a timely plan review): <br /> lop <br /> 12 <br /> Plt�. �d• - <br /> ST - ell <br /> e <br /> 4- List of equipment to be used /4thdc�t ` . <br /> - - - - - -- - ( -pufoau�sspecffcafion-sfieet"howing-ihi <br /> zoo <br /> C. <br /> ��l c5�1114 tof\0 �i4�o <br /> ------------ <br /> _ . . <br />