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c � <br /> SAN0 A Q U I N S Enviro enta ealt a � rti nt <br /> -- COUNTY -- , REUt VED <br /> UST SYSTEM RETROFIT OR REPAIR NOV ) 8 2019 <br /> (Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br /> 1 . Site map enclosed ? YES [ ] NO [ ] ENVIRONMENTAL HEALTH <br /> DFPARTMENT <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 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 <br /> diagram drawn to scale showing location of repairs and/or replacements . If repairing a component, describe <br /> how this will be done . ( If adding 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 /> Remove and replace 87 / 91 fill sump electrical fittings from rubber to bonded <br /> Fiberglass . Pressure test with EHD present. Upon completion of test , place Brine solution <br /> in sumps with present . Install 3 new OPW overspill containers . <br /> 4. . List of equipment to be used (Attach manufacturer' s specification sheets showing third-party approval) : <br /> Bravo FmW7 RETROFIT-SD -AB Fiberglass Entry Fittings <br /> Xerxes Calcium Chloride <br /> 5 . Decontamination Procedures : <br /> a . Will piping be decontaminated prior to removal ? YES [ ] NO [ ] <br /> b . Identify contractor performing decontamination : <br /> Name Phone (..j <br /> Address City Zip <br /> 3of6 <br /> I <br />