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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.ICC Service--Technician-and/or Installer's certificate and all manufacturer training certificates for <br /> each person-installing-or-testing-any-component that-isrepair-ed-or_replaced___Ensure a-copy of the"Site Health <br /> and Safety 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 <br /> drawn to scale showing location of repairs and/or replacements. If repairing a component, describe how this will <br /> be done. .(If adding,pipng, UDC's,_._or other--UST-equipment,_or performing tank top upgrade, use the UST <br /> Installation Application pages 4-8 as necessary for a timely plan review): <br /> WADI I i- <br /> l , <br /> CA L <br /> � U <br /> �,.. <br /> f <br /> 4:— List-of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br />