Laserfiche WebLink
FPb 19, 10 01 : 48p Elite IV Contactors 12094616342 p. 2 <br /> 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? YES[] NON ALC-EQ"( � V�= }'tC;i`1. G`C�L^il���► 1 (1�t�[ , <br /> 2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates for each <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 48 as necessary for a timely plan review): <br /> AC IbL <br /> n Wk , r =rbc o R La <br /> 1p <br /> ft - <br /> ALL <br /> J�1CC 3 A FL X FOL L18t u l ivr l WE n � `f' 1, �r►t ;,t� P ` <br /> - <br /> C <br /> i`1F1h11T M' M_ i ED &NC(Jh 5aO FAA t=S C49#4 C NLI,I N At 1(.CELL_ft Jr� <br /> P(to Rlluf' 1 M-A C aP , uixl <br /> 4. List of equipment to be used(Attach manufacturers specification sh ets sh . "'-' -arty approval): <br /> X10 5 ME bt c=al D iMe.-MF\C Pf l -i� (Vl<) -1[ 0 <br /> !AWN <br /> V _ _\ 164MVI _ 152 101 . 8- MAKr <br /> -SDP- TEWAr/ 3) _ . <br /> V/_a�w -1* LC, r —S.q f <br /> (4) 6VA ; CLOW` ;ELLr 5 : Ccs my _ b. <br /> 2 ..: <br />