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,n <br />UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of plans & applications as originals will be -retained by EHD) <br />1. Site map enclosed? YES [ j NO C l <br />Z. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates for <br />each person installing or testing any component that is repaired or replaced. Ensure .a copy of the "Site Health <br />and Safety 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 <br />drawn to scale showing location of repairs and/or replacements. If repairing a component, describe how this will <br />be done. (if adding piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST <br />Installation Application pages 48 as necessary for a timely plan review): <br />#�_ 1,r/�'I�I���l/moi►!��IL�!'+�.ft1 ��I/.' . <br />-1 <br />_. List of equipment to be used (Atiachrrtanufactucer's specification ets_showin shethi <br />-- g cd-pariY approval): -- _ <br />t <br />r e <br />3 <br />i <br />