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4 <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[] NO [] <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 />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): p 4 <br />�11 .1A11 <br />1 -42 J 0 (--� I 4A I <br />List of equipment <br />to�be used (Attach manufacturer's specification sheets showing third party approval): <br />0 W <br />?f-At <br />VIA VW <br />19,1 <br />P70 4 <br />A <br />3 <br />MAR 3 <br />-NVIRONMENTA1 <br />