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9 0 <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, 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 /> "cr <br /> �P1.Ac+4C Psi. o Os'0 Ives- F� P ®8s�'s <br /> JA Lea Ary► t -1 d- L340 SYS <br /> oN ®*X3 f&,#y — rpt® T cwS Ve ILS PONS£. -- "Jwry+ S sys- F'cx��.t0 <br /> w F opus S R t-pL £ e. P u Z 80 RA-0 F',TIL." Aa£ <br /> ®s.o A ^Y.j O ftpe F4 Pres Lit an+w,�t G , t,..t — L-7 POS, o <br /> Rm� S &Lx SNcrr 00">CC 5 u P Pe.Y -- &*-bby oC 20.4 1 7.S. <br /> FAePL.ft=S6 tM 8"nM ar�►a s�J® -t'`g Qo R€S poet <br /> 5GUSDE6 60gm 'TL6 Foa-W%* p84-1014q0-07-2. <br /> " SftJ 80 505'7 ► Soy®o1 <br /> RfPLorcgD <br /> 4. List of equipment (Attach manufacturer's specification sheets showing third-party approval): <br /> ew po-D Ta.s 3 2.013ft-o4 t <br /> E�Pu2 w/51D0r0J#Ve-€. 'CzS e),31 <br /> M®'M£R Pt O 'i GS I 4A 2S7 <br /> 3 <br />