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w <br /> V E D <br /> UST SYSTEM RETROFIT OR REPAIR <br /> lffMENT <br /> (Submit minimum of 3 sets of plans & applications as originals will be retained by H " <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 /> 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 4-8 as necessary for a timely plan review): <br /> Remove existing dispensers, install 1 and 1 E85 dispenser <br /> Install Bravo conversion frames <br /> Possible cold start <br /> Convert 89 tank to E85 <br /> Install E85 overfill valve -VMI E85 leak detector <br /> Install New Sump Sensor <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval) : <br /> 2) Gilbarco 700S <br /> 2) Bravo conversion frames <br /> 1 ) OPW E85 overfill valve 71SOM412C <br /> 1 ) VMI 99 LD2000 <br /> 1 ) Veeder-Root 794380-323 Position Sensitive Pan Sump Sensor <br /> EH230038 (revised 12-11 -15) 3 <br /> i <br />