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0 <br />UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />Site map enclosed? YES [ I NiW <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 eqed b <br />as ruiry Title 8. <br />I 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 />MA491M Piping, UDC's, or other LIST equipment, or performing tank top upgrade, use the UST Installation Application <br />pages 4-8, as necessary for a timely pla� re <br />J1 <br />L L4) <br />4- List of equipment to be used (Attach manufacturer's specification <br />sheets showing third -party approval): <br />K <br />