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UST SYSTEM RETROFIT OR REPAIR <br /> (Submit min mum of 3 sets of plans&applications as originals will be retained by EHD) <br /> 1 Site map andosed7 YES I 1 NO D9 <br /> 2 Sul r"*oopiss of ICC 'Service Technician andtor Installers certificate and all manufacturer training certificates for each <br /> WSW inslBut"or testing any component that is repaved or replaced Ensure a copy of the 'Site Hearth and Safety <br /> Plan'is availalAe on the jobsite as required by Title 8. <br /> 3 Detailed description of work lobe completed. List components to ba repaired or replaced and attach a diagram drawn <br /> to scale Showing location of repairs andror replacernents. tf repairing a component, describe haw this well be done. (If <br /> adds 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 tamely plan review): <br /> fl CGS <br /> 4 List of equipment to be used manufacturers specification Sheets showing third-party approval); <br /> 4 <br />