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SAN1 Q 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 [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 /> 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 /> Scope of work to install leak detector: <br /> Replace existing OPW itouch monitoring system with a Pneumercator TMS2000 <br /> Fish electrical wiring thru existing conduit (no breaking of concrete needed ) <br /> Install one inventory probe with high/low float kit <br /> Install two sensors= one for each sump; Install one interstitial sensor ; Install PLLD <br /> Program monitoring system ; Test sensors and probe <br /> Perform tank test <br /> 4 . List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval ) : <br /> Pneumercator TMS2000 Series Two Tank Gauging System w/EPA Compliant In -Tank & Secondary <br /> Containment Leak Detection <br /> Magnetostrictive , Dual Float, with reflection resolution doubling Probe <br /> LS600LD- Containment Manway & Piping Sumps Dispenser Pan Float <br /> M2 BAC Net Module <br /> ModBus RTU Interface Cards provide simple , efficient connectivity between TMS/LC2000 systems <br /> MP450S Level Gauging Probe , PK2-RM Riser Mounting Kit <br /> LS600LDBN- 1 Secondary Containment Leak Sensor & LLP203- 1 Pressure Line Leak Detector <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 />