Laserfiche WebLink
SA N ` } { O A Q {UI IN <br /> Environmental Health Department <br /> _ ., C 0 UN it"NY ._ .._._. . <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 [Xj NO [ ] <br /> 2 , Submit copies of ICC Service Technician and/or Installer' s certificate and all manufacturer training <br /> certificates for each person installing or testing any component that is repaired or replaced , Ensure a copy of <br /> the " Site Health and Safety Pian " 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 <br /> diagram drawn to scale showing location of repairs and/or replacements . if repairing a component , describe <br /> how this will be done . ( If addin piping , UDC' s , or other UST equipment, or performing tank top upgrade , <br /> use the UST installation Application pages 4 -8 as necessary for a timely plan review) : <br /> Saw cut and remove existing waste oil spill bucket, <br /> Install New OPW Edgel , 5 Gallon single walled spill bucket and straight drop tube. j <br /> 4 , List of equipment to be used (Attach manufacturer' s specification sheets showing third"party approval ) : <br /> OPW Edge 1 , Single walled Spill Container <br /> OPW 61T Drop Tube <br /> 54 Decontamination Procedures : <br /> a . Will piping be decontaminated prior to removal ? YES [ ] NO [ <br /> b . Identify contractor performing decontamination : <br /> Name Phone ( ) <br /> Address City Zip <br /> 3of6 <br />