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UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 3 sets of plans&applications as originals wlll'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 mar)ufacturer tr��pfeg G �tjfl6 tg or gach.. <br /> person installing or,testing any component that Is repaired or replaced. Ensure a copy of the",Site Health and Safety <br /> 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 diagram drawn <br /> to scale showing location of repairs and/or replacements. If repairing a component, describe how this will be donor (if <br /> pdding piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST installation Application <br /> pages 48 as necessary for a timely plan review): <br /> Cho Rae % Rr � 1 KJ) <br /> da <br /> a Irra Il�t1 r hc�UF ±.:to r� <br /> 4. List of equipment to be used(Attach manufac tJrer's spedlflcallon sheets showing third-party approval): <br /> -- - -- <br /> ------ <br /> I <br /> l.; <br /> ,. . . a •AI , �} � � f�tt� 11 i IYI 11 ��. � ��il�ti. 11 <br />