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UST SYSTEM RETROFIT OR REPAIR <br /> l (Submit minimum of 3 sets of plans&applications as originals will be retained by EHD) <br /> 1 1. Site map enclosed? YES[I NO[I <br /> 2. Submit copies of ICC Service Techniciant that Isnreplalred or retipolacedte ndall EnsurenafCopyrer oftthen'Site Health and Safety <br /> s for each <br /> person installing or testing any compo <br /> plan"is available on the jobsite as required by Title 8. <br /> aired or <br /> and attach a <br /> 3. Detailed description of ott n o repairs anto be d/ored.replalst ceme reonents to be placements. If pairing a component,descrdibe how this will diagram doe.(If <br /> to scale showing to <br /> jdWM 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 /> r <br /> PA 0 <br /> � j <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> nn?1 Iu <br /> PrE) <br /> -O 2_ <br /> 2 <br /> M1[A,1 �C&A cCrV\1 <br />