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0 <br /> UST SYSTEM RETROFIT OR REPAIR <br /> -(Submit-minimum-of-3-sets of-pians&-applications as-origlnals-will-b-e-retained-by-EHD) <br /> 1. Site map enclosed? YES[,3 NO [ <br /> 2. Submit copies of(CC Service Technician and/or Installer's 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 4-8 as necessary for a timely plan review): <br /> Replace one(1)3/4"electrical penetration with Bravo SWAT repair penetration at T-5 STP sump. <br /> Replace one(1)2"LCX siphon penetration with Bravo SWAT repair penetration at T-5 STP sump. <br /> Fiberglass sump collar with 4 layers of matting at T-5 STP sump. <br /> Ri <br /> -, <br /> -x-17 <br /> ENVIRONMENTAL HEALTH <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> (1)BR-F-20-RETROFIT-S-LCX(2"Bravo SWAT LCX repair penetration fitting) <br /> (1)BR-F-07-RETROFIT-S(3/4"Bravo SWAT electrical repair penetration fitting) <br /> Bravo fiberglass matting,resin and catalyst <br /> EH230038(revised 7-26-2016) 3 <br />