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UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of plans & applicaEions as uriginals will be retained by EHD) <br />1. Site map enclosed? YES [ ] NO <br />2. Submit copies of ICC Service Technician and/or installers 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 />S. 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 />addin piping. UDC's, or other UST equipment, or performing tank top upgrade, use the OST installation Application <br />pages 4-3 as rieoessery for a timely pian review); <br />7-0 W <br />4. Ust of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />MAI IN aill Twl <br />2 <br />