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i <br /> t <br /> UST SYSTEM RETROFIT OR REPAIR <br /> I (Submit minimum of 3 sets of plans&applications as originals will be retained by EHD) <br /> 1. Site map enclosed? YES <br /> [l 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 Safe <br /> Plan"is available on the jobsite as required by Title 8. Safety <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 /> (�1� (1iii i ��rnc��►> X jn-TIN -1 \1ML i9 Ci I n ryY <br /> i NF 7 DTA ak Am� <br /> m) dMAE011 <br /> I <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third- a f <br /> g -party,approval): <br /> J <br /> 3 <br />