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AMENDMENT TO SR0082082 AMENDMENT TO SR0082082 <br /> J A N,-,J O n QU I N Environmental Health Department <br /> �_-C O U N T Y----... <br /> UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 3 sets of pians&applications as originals will be retained by END) <br /> 1. Site map enclosed? YES[] NO[I <br /> 2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training <br /> certificates for each person installing or testing any component that is repaired or replaced. Ensure a copy of <br /> the"Site Health and Safety Plan"is available on the Jobsite as required by Title 8, <br /> 3. Detailed description of worts to be completed. List components to be repaired or replaced and attach a <br /> diagram drawn to scale showing location of repairs and/or replacements. If repairing a component, describe <br /> how this will be done. (If adding piping, UDC's, or other UST equipment, or performing tank top upgrade, <br /> use the UST Installation Application pages 4-8 as necessary for a timely plan review): <br /> Remove 6 existing dispensers,install 6 new dispensers. <br /> Install 6 Bravo Conversion Frames <br /> AMENDMENT: <br /> Bravo Conversion Frames were not needed for Installation of new dispensers. <br /> Informed EHD on 1211012020, that Cold Start would be performed on 1211012020. <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> (6)Wayne Ovations 3+1 <br /> (6)Bravo Frames CONV-82000 <br /> Bravo Frames were needed fol U5 instgIlment. <br /> 5, Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES[] NO[] <br /> b. Identify contractor performing decontamination: <br /> Name Phone(�) <br /> Address City Zip <br /> 3 Qr 6 <br />