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,Nov 07 14 03:34p E1iA IV Contactors 120946342 <br />P.2 <br />UST SYSTEM RETROFIT OR R1:: ,AIR <br />RWOTIVED- <br />(Submit minimum of 3 sets of plans & applications as originals.v I be retalned by'F-Hb)O 7 2014 <br />1. Site map enclosed? YES[) NO[] E-NVMONMENT AL HEALTH. <br />2. Submit copies of ice Service Technician and/or installer's certificate and all n anufacturer training certificates for each <br />person installing or testing any component that is repaired or replaced. Eng: a _: a copy of the Site Health and Safety <br />Plan" is available on the 9obsite as required by Title 8. <br />3. Detailed description of work to be completed. List components to be repaired )r replaced and attach a diagram drawn <br />to scale showing location of repairs and/or replacements. If repairing a comlx sent, describe how this will be done. (If <br />adding piping, UDC's, or other UST equipment, or performing tank top upgia % use the UST Installation Application <br />pages 4-8 as necessary for a timely pian review): <br />4. List of equipment to be used (Attach manufacturer's specification sheets showi: 9 third -party approval): <br />3 <br />