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SAN 10 A Q U I N Environmental Hea let `/� E <br /> COUNTY D <br /> UST SYSTEM RETROFIT OR REPAIR AUG 2 4 2023 <br /> Submit minimum of 3 sets of plans & applications as originals will be retained bEEVIROIVMENTq � HEALTH <br /> ( p pp g y � RMIT/SERVICES <br /> 1 . Site map enclosed ? YES [v] 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 /> Remove fuel from premium and midgrade tanks . Clean and haul off rinseate . Excavate <br /> down to vapor mainfold . Disconnect vapor mainfold from premium tank . Test line for <br /> tightness . Backfill and pour concrete to match . Premium tank will become diesel tank . <br /> Add fuel to diesel tank for testing purposes and inspections . Remove and replace (6) <br /> Gilbarco Encore Advantage 3 + 0 with (2) new Gilbarco E700 3 + 1 and (4) new 3 + 0 . <br /> Replace shear valves . Midgrade tank will become premuim tank . <br /> 4 . List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval) : <br /> (2) Gilbarco E700 3+ 1 dispensers <br /> (4) Gilbarco E700 3+0 dispensers <br /> 5 . Decontamination Procedures : <br /> a . Will piping be decontaminated prior to removal? YES [ ] NO <br /> b . Identify contractor performing decontamination : <br /> Name Adams Services Phone3( 10 ) 523-4430 <br /> Address 406 E . Alondra Blvd . City Gardena Zip 90248 <br /> 3of6 <br />