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Orlando ' s 18754 S . HWY 26 , Linden <br /> SANJOAOUIN Environmental Health Depaitment <br /> C CSU NTY .- <br /> UST SYSTEM RETROFIT OR REPAIR <br /> ( Submit minimum of 3 sets of plans & applications as originals will be retained by END ) <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 8 . <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 /> Annual Monitor Cert found spill buckets failed test <br /> 91 ) Repair spill container <br /> 87 ) Replace 5 gallon spill container in sump <br /> Diesel ) Replace exsisting direct bury spill container with new replaceable spill container <br /> 4 . List of equipment to be used (Attach manufacturer' s specification sheets showing third-party approval) : <br /> 91 ) 1 Franklin Fueling / Phil -tite 85036- 1 Outer spill bucket U -shaped seal <br /> 87 ) 1 Franklin Fueling / PhikTite 85000 Replacement Spill Container <br /> Replacment parts for 91 and 87 spill containers are like for like parts <br /> Diesel ) 1 OPW 1 -2200 Replaceable Single Wall Spill Container <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 /> 3 of 6 <br />