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Jan 12"10 01:52p Elite 7V Contactors 12094616342 p.l <br />I/ 2cr <br />UST SYSTEM RETROFIT OR REPAj' __ <br />(Submit minimum of 3 sets of plans & applications as originals will bQ#ned by EHQ) <br />1. Site map enclosed? _ YES [ ] NO [ I <br />l .y! <br />2. Submit copies of ICC Service. Technician and/or Installer's certificate and all man ufacture�4ni v j�'f{�ates for each <br />person installing or testing any component that is repaired or replaced. Ensure a cop�y�f the "Site 11e�lth and Safety <br />Plan" is available on the jobsite as required by Title 8. <br />CD, <br />3. Detailed description of work to be completed. List components to be repaired or replaced`anti:_attsh diagram drawn <br />to scale showing location of repairs and/or replacements. If repairing a component, describe how thtt ll be done. (If <br />adding piping, UDC's, or other UST equipment, or. performing tank top upgrade, use the U� <br />�Installation Application <br />pages 4-8 as necessary for a timely <br />plan -revi`ew�}(:y�,` � �� ,��"��,�:•- a2 _ <br />1Q . <br />I. <br />4. List of -equipment -to be used (Attach manufacturer's specification sheets showing third -party approval): <br />2 <br />