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9255517888 Line 1 101"L34 a.m. 12-31-2009 5/14 <br /> U,-*T 0 1 civil mr-i muri 1 UK mr-ii-jr <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. LW components to be repaired or,'replaced and attach a diagram drawn, <br /> to scale ;shovoing location of aepairs and/or replamnents. If repairing a component, describe how this will be done. (IV: <br /> adding pipin g,,UDC's, or oftr LIST equipment,�or performing tank top upgrade, use the UST Installation Application- <br /> pages 4-8 as necessary for a timely plan.review): <br /> REPLACED 87&91 AUX SIPHON JETS,PERFORM LEAK DETECTION TEST. <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval): <br /> SIPHON JETS <br />