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i <br />-- - — -- - -_–AbST SYSTEM RETROFIT • RlE <br />OR <br />(Submit minimum of 3 sets of plans &'applications as originals will'be retained by EHD)' <br />1. _ Site map enclosed?_._ YES [] __. _ NO <br />Z Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training cgrtificates 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 thejobsite.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, ,UDC's, or other UST equipment, or performing tank top upgrade, use the LIST Installation Application <br />pages 4-8 as necessary for a timely plan review): <br />a • <br />7_� a , <br />. j <br />(' <br />.L -2014.I <br />I <br />4. List of equipmentto be used (Attach manufacturer's specification sheets showing`third-party approval): <br />r <br />