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Y <br /> ' t <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 <br /> 2. Submit copies of ICC Service Technician and/or Installer's certificate and.all-manufacturer.training_certificatesfor 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 /> dding 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 /> G3l0'l�te�ficc� <br /> t. a44 n( Q) .t ro.-A ls.0 rci <br /> �rr� �irInnf) h4] i115iCUJ 80t�SaQ d S qj . *t e� _ <br /> f i 11 5 M05 . 61NUX- d t Cconcat - ()CeJ a! od <br /> � <br /> PeKTfCJLM t n Ab q! 1QTbl )L1. 5l`,n . <br /> 0 7cn)a c,o F .4 /�Iy�c11 .� <br /> p.p t fS ,1 n�i at �► �1 LTc;zl:)c,aF 1 ,.cC�Vao(sf jp nw traI t 60,S <br /> �nb of irl� ) CL—OTC-)L,OF 2� UzA r l FiJ)C1[a b(r\ 4, bn t 113kh ) * I can <br /> �! �.l_�. o �sr�aL o� Cr n5n�ckr<�n t� inn. Q fLcaA <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> 3 E5 t <br /> 1�1 fill <br /> U rr <br /> f ♦ . .. r ♦1 ' <br /> .♦♦il- a.l � Ik l r,'�♦.A�.d 1 y�} 1"� , 1 � 11 1 1 ►♦1� � ,�j �t1 K 1 <br /> .�r,9r,.1 4 M t tl ♦ 1 ♦ 1/-;4♦��R ,, )1,�'1 ��. 1 1 -'/ 1�`:, 111'" Itr;�:r♦.1 1♦ f <br />