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El <br />El <br />UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EH/ealth <br />1. Site map enclosed? YES [ ] NO <br />2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer traininfor each <br />person installing or testing any component that is repaired or replaced. Ensure a copy of the "Sd 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 andAttach a diagram drawn <br />to scale showing location of repairs and/or replacements. If repairing a component, describ ow this will be done. (if <br />addin piping, UDC's, or other UST equipment, or performing tank top upgrade, use the ST In <br />Application <br />pages 4-8 as necessary for a timely plan review): <br />Replace existing AutoStik ATG, probes & sensors with Veeder-Root TLS -350 ATG, pr es & sensors. <br />4. List of equipment to be used (Attachmanu cturer's specification sheets showing third -party approval): <br />1 ea: 848290-122 - Veeder-Root TLS -350R ith Probe &Interstitial Sensor Interface modules) <br />2 ea: 846390-107 - Veeder-Root Probe <br />2 ea: 794380-208 - Veeder-Root 208 ump sensor <br />2 ea: 794380-301 - Veeder-Root ingle Float Annular Space Sensor <br />2 <br />