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y <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[I NO[] <br /> 2. Submit copies of[CC Service Technician,and/or, <br /> Inst aller'.s certificate and all manufacturer.training_certificates.fior 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 /> pdding 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 /> t�y len K5 ���i , <br /> 4. List of equipment to be used(Attach manufacturer's spedification sheets showing third-party approval): <br /> r <br /> �acuxn <br /> 56ry-�20 <br /> -- __-..---- - -- - _ <br /> a . <br /> i <br /> �i�IA }V <br /> rr,,i'. ♦ Y / r� ! r Ii.y1 w;. ,�:i. 1.«�i'. 1 �1 Y A ,4 A ,, ♦ i1 11;.'.•'�{� rwn ,1r.x,F�'y,i <br />