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SA N 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 P9 <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 fuel from tank. Expose and remove manway (break out and remove 8'x8' concrete <br /> around sump, remove piping, electrical, sump, and pea gravel, shore-up excavation). Prepare <br /> tank for safe entry (clean,vacuum,and defume). Enter tank, inspect and repair if possible. <br /> Close Tank. Test Tank. Re-install piping,electrical, removed tank top.Test Tank. After approval <br /> from EHD put tank back into service <br /> Revised 9/17/2024: At the time of tank entry we will perform an inspection,and if possible to repair, repairs will be made <br /> See attached scope of work from Containment Solutions/NOV and Bagley <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval): <br /> Containment Solutions/NOV, the tank company, will clean tank bottom,inspect, and repair if <br /> possible_ Sump P/N SWPTS (WT34)42/8 <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 /> 3of6 <br />