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r , <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 mYES[] ..... NO _ -'..._. ...- .. . <br /> 2'. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certifjcates for each <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']obsite as required by Title a. <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 flow this'...... e done: (If <br /> adding piping, UDC's, or other UST equipment, or performing tank top:upgrade-use_the_UST.Installation-Application <br /> pages 4-8 as necessary for a timely plan review): <br /> .. C <br /> A"n <br /> -tou <br /> Tau. mfi�_L <br /> U � <br /> . <br /> gtg'I - ✓QP4_,� r7_J_ <br /> • <br /> 4. Ust of equipment to be used(Attach man4facturer's specification sheets.showing,third-party.approval): , <br /> —_- ---- r--------, <br /> 3 <br />