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T SYSTEM RETROFIT OR REP <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 ;installingor testing any component that is repaired or replaced. Ensure a copy of the "Site Health and Safety <br />Plan". is availableon 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 showinglocation 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 48 as necessary for a timely plan review): <br />OCTED <br />2 4 2014 <br />ENYIRONMIENTAL HEAL <br />DEPARTMENT <br />3 <br />! <br />•6 <br />+ <br />3 <br />