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Jul 25 13 05:27a Reliable Petrol- .m 2r -458953 p.21 <br /> RECEIVED <br /> UST SYSTEM RETROFIT OR REPAIR JUL 2 5 2013 <br /> (Submit minimum of 3 sets of plans&applications as originals will be retained by�ll[�lRO <br /> EPARMENT <br /> 7. Site map enclosed? YES[] NO[> HEALTH DTT <br /> 2. Submit copies of ICC Sertice 7echnician and/or Installer's certificate and all manufacturer train rg certificates for each <br /> person ins*aliing 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 requ red by Title 8. <br /> 3. Detailed description of work to be completed. List components to be repaired or replaces and attach a diagram drawn <br /> to scale showing location of repairs and/or replacements. If repairing a component, describe now this will be done. (If <br /> acdica piping, JDC'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): / <br /> int j 1 <br /> > 02 <br /> 4. List of equipment to be used(Attach manufacturer's specificatioi sheets showing third-party approval;: <br /> 3 <br />