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(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />1. Site map enclosed? YES V 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, LIDC'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 />CONVERTING HEALY VACUUM ASSIST SYSTEM TO EMCO WHEATON BALANCE SYSTEM PER EXECUTIVE ORDER VR -204. <br />REMOVAL AND REPLACEMENT OF EXISTING DISPENSERS AND HANGING HARDWARE. <br />REPLACE EXISTING SPILL BUCKETS WITH NEW FFS DEFENDER SERIES FILL AND VAPOR SPILL BUCKETS IN NEW MANWAYS. <br />INSTALL FE PETRO 2 HP SUBMERSIBLE PUMP. f 71 <br />INSTALL SUMP SENSORS IN UDC'S AND SUMPS. <br />AUG 12 201 <br />EENW11BObi MENTAL HEALTH <br />DEpARTMENT <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />INSTALL NEW DRESSER-WAYNE OVATION B-12 DISPENSERS WITH FACTORY INSTALLED HI -HOSE RETRACTORS AND ISD FLOW <br />INSTALL NEW EMCO WHEATON BALANCE DISPENSER NOZZLE AND BREAKAWAY AND GOODYEAR EVR HOSES. <br />INSTALL NEW VEEDOR ROOT 208 SUMP SENSORS. <br />REPLACE 3 PUMP WITH 3 NEW FE PETRO 2 HP SUBMERSIBLE PUMP WITH MAG VARIABLE FREQUENCY CONTROLLER, <br />INSTALL NEW BRAVO CONVERSION FRAME FOR NON -BRAVO DISPENSERS, <br />INSTALL NEW POWER INTEGRITY DISCONNECT FOR LOW VOLTAGE CIRCUITS AND DISPENSER DATA/CREDIT CARD DISCONNECT. <br />REPLACE SPILL BUCKETS WITH NEW FFS DEFENDER SERIES FILL AND VAPOR SPILL BUCKETS IN NEW MANWAYS. <br />2 <br />