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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 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 a necessary for a timely plan review) : <br /> Install ( Single Product DSL Gilbarco 700s Encore dispensers with Bravo conversion frames <br /> at � nd 11 / 12 . <br /> Updated to include : <br /> Replace OPW drop tube on DSL . <br /> 4 . List of equipment to be used (Attach manufacturer' s specification sheets showing third -party approval ) : <br /> Gilbarco Encore 700 <br /> Bravo Conversion frame <br /> i <br /> c <br /> EH230038 (revised 12- 1 1 -1 5) 3 <br />