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Addendum SR00832. 63 <br /> AN <br /> ` ( ( � (1 I � I Environmental Health Department <br /> - --w C d UUN T Y --.- . <br /> 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 N NO I <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 8 . <br /> ' 3 . Detailed description of work to be completed , List components to be repaired or replaced and attach a <br /> lagram drawn to scale showing location of repairs and/or replacements , If repairing a component, describe <br /> how this will be done. ( Ifdp ding 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 /> Diesel linerp imary line seeping between dispensers # 10 & 11 <br /> Permit request to inyao%tlgatP to dPtPrmminP what will hP needed . <br /> permit to be undated with scope of work & material once determined <br /> 4/01 /2021 * *- Scope of work : After investigating founda leak in diesel prima pipo <br /> between dispensers # 13 and around to 14 . <br /> Remove 10 to 15 feet of 2 inch diesel primary product pipe and re lace , due to <br /> leak Upon completion of repair pressure test primary line & secondary lines _ with <br /> EHD present . <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval) ; <br /> 1 ) Primary Piging - Red Thread IIA 2 inch /50mm 011020-069A 15 feet <br /> 1a) Primary Fitting - Red Thread IIA 2 inch 90 degree Elbow ( belled ends ) 012020 - 3604 <br /> 2 ) Secondary Containment Piping - Red Thread IIA /3 inch / 80mm 011030 -069 -4 15 feet <br /> i <br /> 2a ) Secondary Containment Fittinqs- Red Thread IIA /3 inch 90 degree Elbow 012030-360 -3 <br /> I. <br /> 2b ) Secondary Containment Fittings - Red Thread IIA /3 inch Tee 012030410-3 <br /> G <br /> 5 , Decontamination Procedures : <br /> a. Will piping be decontaminated prior to removal? YES Q NO [ j <br /> b. Identify contractor performing decontamination: <br /> Name Elite IV Contractors Phone (209 ) 461 -6337 <br /> Address 2535 Wigwam Drive city Stockton zip 95205 <br /> 3 of 6 <br />