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UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br /> 1. Site map enclosed? YES I I <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 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 UST equipment, or performing tank top upgrade, use the UST Installation Application <br /> pages 4-8 as necessary for a timely plan review): /9" yyy/Jiv�tryGG f0/{ <br /> THS vee��r � j,y� k �,� ✓u6x-/ r��c <br /> ` /JIG O/Jayni 0 / X OOS /516 !� <br /> .;E0 4-CG /0 T 1"C C <br /> �1'n-!J �L� C •9�, <br /> /t ,,r I-L6X /3 tiV T <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval): <br /> 7Ff /`Y�IJ lti(e- v`L�C 4,C— 016 "M- ^, TCJ .2'%,7 7Via <br /> T4/Lr /t C Srf/L kNi re-/ / 1 iQ e_X ClZ <br /> ` /�AT.1GGi/iC- <br /> la � ti <br /> y � D 6 y d o <br /> ti �� <br /> 5r,X� /tI5AK <br />