Laserfiche WebLink
v � <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[] N0 <br /> 2. Submit copies of ICC Service Technician and/or installer's certificate and all manufacturer training ce cates for each <br /> person installing or testing any component that is repaired or replaced. Ensure a copy of the"Site ealth and Safety <br /> Plan"is available on the jobsite as required by Title B. <br /> 3. Detailed description of work to be completed. List components to be repaired or replaced a attach a diagram drawn <br /> to scale showing location of repairs and/or replacements. If repairing a component, descri how this will be done. (if <br /> goN piping, UDC's, or other UST equipment,or performing tank top upgrade, use t UST Installation Application <br /> pages 4-8 as necessary for a timely plan review): <br /> eg"— 2030 MUD <br /> mild-34, EL I <br /> ei U �Y1�6 L S °I nu kr spact- <br /> 4. List of equipment to be used(Attach nufacturer's specification sheets showing third-party approval): <br /> VMI 99-LO-2000 D <br /> 2 <br />