Laserfiche WebLink
f 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[] NO'N <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 /> ll t c S ' c Q b <br /> In 'A (C 5 i <br /> or)(3b DO i r <br /> C4 0 0 u C1� �i.(I 0 Doub f WCC1 i trir <br /> to � ) f e;Ncre-c1 l b lac�kc1 i N <br /> oksj <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> �e�e.r - rpt �eX�SU� •� � 7 �'�:�s� -3c:�+- 3 <br /> C6 oefr)yrafi rl <br /> i <br /> ., r f , i + 1 +f�_ .. ?-�. ' R ,,.. f , 4 • : + y + i•'Y¢ •a•h <br /> i • <br />