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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 Pq 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(6)existing dispensers and set aside for sale or disposal. <br /> Install Bravo CONV-62000 conversion frames and Encore Deflector Plates. <br /> Install,setup and commission(6)Gilbarco Encore 700S Dispensers. <br /> Furnish and install wire and piping to transition to new dispensers. <br /> Install,setup and activation of Applause Media. <br /> Program and map Veeder-Root ISD software to P.O.S.(Point Of Sale). <br /> Schedule and conduct final inspection with CUPA and Air District(as required). �VFD <br /> Replace leaking Fireguard 12"x 1.5"flex line in dispenser 7/8 on diesel product. <br /> �J tvlC) <br /> `NT.AL HFAI ` <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval): <br /> Bravo CONV-62000 UDC conversion frame <br /> Encore Deflector Plate <br /> Gilbarco Encore 700(3)3+0 and(3)3+1 Dispensers <br /> Fireguard 12"x 1.5"Flex Line <br /> EH230038(revised 7-26-2016) 3 <br />