Laserfiche WebLink
To: Elena Manzo Page 4 of 11 2018-08-29 19:10:31 (GMT) 17076380484 From: Nucleus Pump Services <br /> 1 ''J Q t Environmental Health Department <br /> TY <br /> UST SYSTEM RETROFIT OR REPAIR RECEIVED <br /> (Submit minimum of 3 sets of plans&applications as originals will be retained by EHD) AUG 2 9 2018 <br /> 1. Site map enclosed? YES11 NO[] <br /> ENVIRONMENTAL <br /> 2. Submit copies of ICC Service Technician and/or Installer's certificate and all man6jtffW ffiuRftj�TMENT <br /> certificates for each person installing or testing any component that is repaired or replaced. Ensure a copy of <br /> the"Site Health and Safety Plan"is available on the jobsite as required by Title B. <br /> 3. Detailed description of work to be completed. List components to be repaired or replaced and attach a <br /> diagram drawn to scale showing location of repairs and/or replacements. If repairing a component, describe <br /> how this will be done. (If adding piping, UDC's, or other UST equipment, or performing tank top upgrade, <br /> use the UST Installation Application pages 4-8 as necessary for a timely plan review): <br /> Scope of Work: <br /> 1. Saw cut out diesel spill bucket. <br /> 2. Remove concrete and diesel spill bucket. <br /> 3. Replace with new 5 gal diesel spill bucket. <br /> 4. Wrapping galvanized pipe at soil penetration. <br /> 5. Testing spill bucket. <br /> 6. Reinstall concrete. <br /> 7. Replace both 91 leak detectors(Vaporless LD-2000 Leak detector). <br /> 8. Complete 3.0 line testing- <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval):! <br /> Vaporless LD-2000 Leak Detector <br /> OPW 5 gal direct bury spill bucket. <br /> 5. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES[J NO[1 <br /> b. Identify contractor performing decontamination: <br /> Name Phone( <br /> Address City Zip <br /> of 6 <br />