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Y }• a ,/; ". Ii'R) yt 1 !• i 1 f 1 t " f 1 1 1} I ♦, R f�� ,} i s 11 11 I <br />I <br />' � r a / 1 ' ,t/.:v;i ti, . a +.} ^ ` « / ♦ , < , , } 'r,i �1. t , ,I � ♦ I ♦ i n } a <br />, <br />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-[] <br />2. Submit copies of ICC 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. Ensue a copy of the "Site Health and Safety <br />Plan..". is..availableon the jobsite, as. required by Title S. ' <br />3. Detailed description of work to.be completed: list. compo} lents 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 lnstallation Application <br />pages 4-8 as necessary for a timely plan review): <br />L__ \ WIMrA <br />4. List of equipment to be used (Attach manufat;turees specification sheets showing third -party approval): <br />VAi <br />. x <br />. ♦ w4 x,; .I�f ,a t a' - - ♦, �� to ';r � <br />a # - r # #♦ « �F « ° ail; i �� # I x ♦ g « # { T '� � r ef.' " 1 Wil � � ,� � - � # _ f t a <br />_ t�.�x r,�{, i a` tx a14, +. ... « '3"5..,. a1w1s��`'1 �• fi1`' a t - <br />