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�7 <br />applicationsLIST SYSTEM RETROFIT OR REPAIR <br />as originals <br />(Submit minimum of plans & <br />1. site map enclosed? YES 1;'�" NO <br />2. Submit copies of ICC Service Technician and/or installer's certificate and all manufacturer training certificates each <br />person Installing or testing any component that Is repaired or replaced. Ensure a copy of the "Site He nd 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 repai>orreplaced d attach a diagram drawn <br />to sole showing location of repairs and/or reps ents. If repairing a covibe how this will be done. (If <br />Addi piping, UDC's, or other UST equipment, or performing tank top upthe UST Installation Application <br />a 4-8 as necessary for a timely plan review): _ ^ <br />4. List of equipmenAo be used (A#8011 man fecturer's specifications s ehowing third -party approval): <br />