Laserfiche WebLink
DATE 111912021 * * A M E N D M E N T Permit# S R 0 0 8 2 5 9 2 !EI Dorado Gas&Mart 1605 S E!Dorado,Stockton,CA <br /> R E PE �VED <br /> SA N `J O A Q U I Environmental Igah{�? pa�lient <br /> C 0U N TY- <br /> �[VIRON[�IINTAL HEALI H <br /> UST SYSTEM RETROFIT OR REPAWR n1\,RTI0NT <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 <br /> certificates for each person installing or testing any component that is repaired or replaced. Ensure a copy of <br /> the"Site Health and Safety Plan"is available on the jobsite as required by Title B. <br /> 3. Detailed description of work to be completed. List components to be repaired or replaced and attach a <br /> diagram drawn to scale showing location of repairs and/or replacements. If repairing a component, describe <br /> how this will be done. (If adding piping, UDC's, or other UST equipment, or performing tank top upgrade, <br /> use the UST Installation Application pages 4-8 as necessary for a timely plan review): <br /> Remove 3 existing dispensers, Install 3 new with bwm Q..r'" <br /> Frames Updated • Wayne Ovation 2 Dispensers with <br /> Updated • Wayne Ovation conversion frames. <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval); <br /> Updated • 3) Wayne Ovation 2 Dispensers <br /> Updated • 3) Wayne Ovation Conversion frames Part# CU-250-CA <br /> 5. Decontamination Procedures: <br /> a, Will piping be decontaminated prior to removal? YES[] NO[] <br /> b. Identify contractor performing decontamination: <br /> Name Phone <br /> Address city Zip <br /> 3of6 <br />