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UST SYSTEM. RETROFIT OR REPAIR <br />,(Submit minimum of=3 sets, of plans & applications as originais will be retained by EHD) <br />" 1 Site map enclosed? YES [ ] N® <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 repai(ed or replaced. Ensure a copy of the "Site Health. and Safety` <br />Plan" is available on 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 showing location of repairs and/or replacements. If repairing a *component, describe how this will be done. flf <br />d� dino•piping, UDC'sfl or other UST. equipment, or performin Unk top upgrade, use the UST Installation Application <br />pages 4-8 as necessary for a time[y plan review): <br />('oldcta S'� A L1C�.Cbeakerl o ®� } r�atlorY <br />SII reolace L-4 f91 annular sensor) <br />5 <br />r <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third-parry approval): <br />Z243904QZ: SENSOR "Annular v 7'5�to 9' FIBERGLASS TANKS ( Veeder_Root <br />2 <br />J <br />