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UST SYSTEM R_E_TROFiT OR REPAIR <br />(Submit minimum'of 3 sets of plans z& applications as originals wili'be retained by EHD).' <br />1. Sitemap._enclosed2. __ . __...:Y.ES.[ j __.........Np <br />2: Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates 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_avallable.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'locatiombf repairs and/or replacements. If repairing a component, describe how this will be done: "(If <br />adding piping, UDC's, or other UST equipment, or performing tank top upgradq, use the UST Installation Application <br />-pages 4-8 as necessary for a timely plan review): <br />f <br />4. List of equipment to be used (Attach man4facturees <br />Z' <br />sheets s. <br />howing,third-party approval): , <br />