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OTS - YSTEM RETROFIT OR RE ' <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />1. Site map enclosed? YES [ l NO[] <br />2. Submit copies of ICG 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 />addrnq piping, UDC's, or other UST equipment, or performing tank top upgrade, use the LIST Installation Application <br />pages 4-8 as necessary for a timely plan review); <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />0 <br />• y+ <br />i • • � i y ` '� 1 • • a <br />+ <br />W <br />r • `• h i y `' i <br />t'1 <br />+ i�'� Y� ! 1 W• F + � <br />n <br />