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SAN J O A Q U I N Environmental Health Department <br /> COUNTY <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 [ ] 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 , LIDC ' 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 and replace existing dispensers and hanging hardware with new dispensers/hanging hardware <br /> with new conversion frames and deflector plates . Remove and replace existing manway covers with new manway <br /> lids . Remove and install existing turbines/PLLD with new F . E . Petro turbines and PLLD with new Petro Mag VFC <br /> frequency controllers and FE Petro STP - DHI dispenser hook isolation box <br /> 4 . List of equipment to be used (Attach manufacturer' s specification sheets showing third-party approval) : <br /> Wayne Ovation dispensers 2@3 + 1 , 2@3 + 0 and 2@3 + 0 single sided <br /> Fiberlite 40 " turbine manway covers <br /> FE Petro 2hp turbines with PLLD w/o swift checks <br /> Gasoline Dispenser hose kits (VST 5 ' hose , VST 8 ' hose , VST balance nozzles , Emco breakaways ) <br /> Diesel dispensere hose kits (VST -6 ' hose , VST4 hose , OPW nozzle , breakaway , swivel and clamp ) <br /> FE Petro Mag VFC variable frequency controllers with dispenser hook isolation box <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 P City Zip <br /> 3of6 <br />