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UST SYSTEM RETROFIT OR REPAIR V� <br /> (Submit minimum of 3 sets of plans&applications as originals will be retained by EHEDCT 16 2014 <br /> 1. Site map enclosed? YES W NO [] <br /> ENVI,9t1RIMER?TAL HEALTH <br /> 2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training&O(•(M[ ach <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): <br /> lurl�l� Annord monitor fe['tific tfon , con(jumon on <br /> StDteMY _e,r 2g1n , 2614 , thf Dyfffill s-Pnmr on fh-e waste <br /> tank FailfD . ( Ronan LS - 3) - �\J-P Will he rfniacing 1ik-P ear <br /> iia ann rTitstina . <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval): <br /> Ronan LS - 3 S-nsor <br /> 3 <br />