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Feb 22 10 04:18p Elite TV Contactors 12094618342 p.l <br />A C)c <br />°2 , <br />UST SYSTEM RE OR REPAIR FEB�E� <br />m of 3 refs of fans& a Gcations as originals will be.retaped b1r EHD) <br />(Sub <br />m�n�mu A Pp;�J <br />Site map enclosed? YES (j NO [ ] t ���; Ft _ 'L <br />s . �', arE�f, e <br />& . 2. Submit copies. of !CC Service. Technician and/or Installer's certificate and all manufacturer training certificates for each <br />personinstalfng or #es#ing any component ifiat is repaired or replaced. Ensure a copy of the "Site Health and Safety <br />Plan" is available an the jobsite as required by Title 8. <br />3. Deiaile'd-description of Work to. be completed: `Ust components to:be repaired_ or replaced and, attach a diagram drawn <br />to scale showing -location of.repairs andlor;replacements: lf. repairing a. component, describe how.this will Abe .done.: (If <br />addin .piping; UDC's; or. other U3T''equipment; ar performing tank top _apgm0k: use the UST. installation Application <br />pages 4-8 as necessary fora timely plan review}:. <br />4. List of -equipment to be used(Attach manufacturer's.specifcation sheets. showing third -party approval): <br />C,, <br />