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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 [ ] NO [ j <br />2. Submit copies of ECC Service Technician and/or installer's certificate and all manufacturer training certificates 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 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. (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 />zC; � .l '• Fr G u. �. GG g 41&ta � `1 �'� ,r.� `1 ...5 Lr u! <br />e) GSC./ I'f d^ f n .✓ ✓�rG'sv1 G� e7 �:a✓ LG Y` C% tp` %� �' <br />Ile,/,; 4 idl'" <br />�l0 sda 6­_1iZ_tf lie- 1111r_1_94;1z C".s <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />if <br />e'i !:.s GJ C� -8-"" .'li r ��i�C / ✓'(� Ci',C"-' jam' -7 /,-i <br />ell <br />03< <br />3 <br />