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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 Installer's certificate and all manufacturer train <br /> irfg certificates for each <br /> person installing or testing any component that is repaired or replaced. Ensure a copy of t�"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 o/sethe <br /> nd attach a diagram drawn <br /> to scale showing location of repairs and/or replacements. If repairing a compone how this will be done. (If <br /> adding piping, UDC's, or other UST equipment, or performing tank top upgradST Installation Application <br /> pages 4-8 as necessary for a timely plan review): <br /> Saw cut concrete perimeter of direct bury fills on Tanks 2 and 3. <br /> Break out concrete and haul off for proper disposal. <br /> Remove(2)existing Fill/Spill buckets from tanks 2 and 3 <br /> Replace Existing 2 Emco Wheaton with Emco Wheaton model# 1004EVR-215A on Tanks 2 and 3 <br /> Schedule Pre-bury inspection <br /> Recieve approval for backfill and patch <br /> Schedule final inspection as required. <br /> Replace (1) 3"x15" Hose Master Flex Connector in bove ground piping manifold in Bio Shed. <br /> t <br /> t' <br /> d <br /> r <br /> j° <br /> ,r <br /> 4. List of equipment to be used (Attach a manufacturer's specification sheets showing third-party approval): <br /> *Diesel Tanks#2 and#3 have 15 gallon Emco Wheaton to be replaced with model#Al 004EVR-215A <br /> 'Bio Shed <br /> Install (1) Icon Split Penetration repair fitting model# IC-RFRIDIG3.5F in UDC 14-15 <br /> Install (1) Icon Split Reducer boot model#ISR3.5X2.4 in UDC 14-15 <br /> AUG 21 <br /> 3 <br />