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UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of pans & applications as originals will be retained by EHD <br />r , <br />1. Site map enclosed? YES O N0 ) <br />� <br />[ 2• Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer <br />person insfaffing or testing any component that is repaired or replaced. Ensure a co of <br />.Plan" is available on the jobsite as required by Titie 8. eaGO training certificates for each <br />PY the "Site Health and Safety <br />3. Detailed description of work to be completed. List components to be repaired or re lac. <br />to scale showing location of repairs and/or replacements. If repairing a component, describe how this .will be <br />addin equipment, P ed and attach a diagram drawn <br />, __CI piping, UDC's, or other UST ui ment, or performing- tank top upgrade, use the UST Installation Application <br />pages 4-8 as necessary for a timely plan review):done: (►f <br />. . <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing .third -party approval <br />3 <br />