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0 <br />UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />11. Site map enclosed? YES [ ] NO [] <br />2. :Submit copies .of [CC 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 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�done. (If <br />,adding piping, UDC's, or other LIST equipment, or performing tank top upgrade, use the UST Installation Application <br />'pages 4-8 as necessary for a timely plan review): <br />0�f(a ocd 2 +6 �i n+ _5��-�'� n(t+ 4- 33254 -rn) <br />4. ',List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />mi a'ID)w poo� <br />3 <br />