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9255517888 ' <br />32�551�8$6' ' <br />Line 1 15:16:16 09-15-2014 2/6 <br />is 0 <br />Line 1{ �d 10:39:04 08-22-2014 2/11 <br />hh v S -4S6 - 3) bC k-l-biq <br />UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />1. Site map enclosed? YES NO [] <br />2. Submit copies of iCC Service Technician and/or installers certificate and all manufacturer training certificates for each <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 location of repairs and/or replacements, if repairing a component, describe how this will be done. (if <br />adding piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST Installation Application <br />pages 48 as necessary for a timely plan review): <br />CONVERTING HEALY VACUUM ASSIST SYSTEM TO EMCO WHEATON BALANCE SYSTEM PER EXECUTIVE ORDER VR -204. <br />REMOVAL AND REPLACEMENT OF EXISTING DISPENSERS AND HANGING HARDWARE. <br />INSTALL 3 NEW FE PETRO2 HP SUBMERSIBLE PUMPS IN EXISTING UNDERGROUND FUEL TANKS AND CONVERT SYPHON TANK <br />TO A ALTERNATING 87 FUEL TANK <br />X <br />DEPARTMENT <br />��7� � �% �/�D 9'Z T�/ie�iy� LiJ1�G Di✓C��i ��2fr1�//�//���t�� <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />NEW DRESSER-WAYNE OVATION B-12 DISPENSERS WITH FACTORY INSTALLED Hl -HOSE RETRACTORS AND ISD FLOW METERS <br />EMCO WHEATON BALANCE DISPENSER NOZZLE AND BREAKAWAY AND GOODYEAR EVR HOSES. <br />VEEDOR ROOT 208 SUMP SENSDRS. ` <br />FE PETRO 2 HP SUBMERSIBLE PUMP WITH MAG VARIABLE FREQUENCY CONTROLLER, <br />BRAVO CONVERSION FRAME FOR NON -BRAVO DISPENSERS, <br />POWER INTEGRITY DISCONNECT FOR LOW VOLTAGE CIRCUITS AND DISPENSER DATAICREDIT CARD DISCONNECT. <br />V4- <br />AarPiV"4 Tim" Allo 51 21114 10.1AAM No 4QQA <br />Received Time Sep.15, 2014 3:07PM No -7050 <br />