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T 3 <br /> UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 3 sets of plans & applications as originals will be retaineid `by EHD )'~ `' ? ` ` <br /> 1 . Site map enclosed ? YES [ NO [ ] / ;y t t � FY <br /> 2 . Submit copies of ICC Service Technician and/or Installer' s certificate and all manufacturer traning ''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 /> Tank # 2 ( 91 ) STP Sump - Product Penetration Secondary Piping Leak <br /> Sawcut , Demolish & Remove Concrete <br /> Excavate & Expose Penetration <br /> Locate Leak in Penetration , Prepare Surface & Apply Epoxy Glue Kit P / N EP - 10ORF <br /> Apply Fiberglass Matting Kit ( P / N : B - 407 - TG ) <br /> Backfill & Resurface Concrete <br /> Perform Any Inspection/Testing as required by Local Agency <br /> 4 . List of equipment to be used (Attach manufacturer' s specification sheets showing third -party approval ) : <br /> P/N EP- 100RF <br /> P / N : B - 407 - TG <br /> EH230038 (revised 7-26-2016 ) 3 <br />