Laserfiche WebLink
. . ^ <br /> / . <br /> LIST SYSTEM RETROFIT OR REPAIR RE G E I V E== <br /> (Submit minimum of 3 sets of plans&applications as originals will be retained by EHD) APR 3 0 2015 <br /> 1Site map enclosed? YES[] NO ��������������������^� <br /> �_u��������������&����u~ <br /> 2. Submit copies of[CC Service Technician and/or Installer's certificate and all manufacturer training odAMhTaTGWAWnr_w/- <br /> person installing ortesting any component that karepaired wrreplaced. Ensure ucopy mfthe "Site Health and Safety <br /> Plan"iaavailable onthe joboheoarequired byTitle 0. <br /> 3. Detailed description ofwork tnbecompleted. List components tmberepaired orreplaced and attach ediagram drawn <br /> \nscale showing location ufrepairs and/or replacements. )frepairing ocomponent, describe how this will bedone. (|f <br /> adding piping, UDC's, or other LIST equipment, or performing tank top upgrade, use the UST Installation Application <br /> pages 4-8asnecessary for etimely plan voview): <br /> Dispenser#314 impact notclosing 87 product <br /> Replace i impact test Bravo Float for shut down <br /> 4 List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> 1 OPW 1 OBFP-5726 Emergency Shutt-Off Valve <br /> 3 <br /> ................... -- ---------__- <br />