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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? ) <br />YES [j NO. <br />2.. Submit copies of ICC Service Technician and/or Installer's <br />person installing or Testing any componcertificate and all manufacturer tram <br />ent that is repaired or replaced. Ensure a co Plan'" is available on the jobsite as required by Title 8. pY of the n rng certificates for each <br />Site Health and Safety <br />Plan' <br />3. Detailed description of work to be completed. List.components to be repaired or re laced <br />to scale showing ►ovation of repairs and/or replacements. If repairing a, component, describe d <br />addiri r rn , UDC's, or other UST equipment, or nts. If <br />tank to u p and attach a diagram drawn <br />_3 .p p 9 ow this will .be done. (if. <br />pages 48 as necessary for a timely plan review): performing P pgrade, use the UST Installation <br />Application <br />LEA <br />At #66 <br />TO <br />P � ' x.16? : • ' : � r <br />8 <br />Y <br />... A Lt6k 6 <br />