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MVP Petrole ng., Inc. <br />*84-1117 p.2 <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[] <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, UDCs, 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 />T ■x;11 t `` <br />4_ List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval}: <br />-�t7 ZMOE /�7-r,�c <br />flv Q Qd2m,7-/ 7? eg" s AJ ,Oo� �i�e� 4r,, �� z <br />