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07/29/2010 10:38 2099433003 APEC PAGE 01/01 <br /> r <br /> S R 0c)(D 0 101 <br /> UST SYSTEM RETROFIT OR REPAIR. Tom- <br /> (Submit minimum of 3 sets of plans u ap inns as originals will beTA ,, by END)314 N , <br /> 1 � � '1. Site map enclosed? YES NO[a 4 . �r w. i G1 "! BIM . <br /> 2. Submit copies of ICC Service Technician and/or Installer's certifi a 1 ufacturer training certificates for each <br /> person installing or testing any component that is repaired or rep 41 n e a copy of the"Site Health and Safety <br /> Plan" is available on the jobsite as required by Title 8. #r4 j0ArjvAj CUJNTY <br /> F,%d 4a�CN41 E Te' L <br /> 3, Detailed description of work to be completed. List components pr _flaced 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 UST Installation Application <br /> pages 4-8 as necessary for a timely plan review): <br /> 7f , bl� -ice v <br /> intr ' <br /> ail 144V <br /> stnaln �' 4aZ <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval)_ <br /> rr�Y� i Q� <br /> L <br /> 2 <br />