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+ <br />UST SYSTEM RETROFIT OR. REPAIR <br />(Submit minimum of 3 sets of plans & applications as originals wili'be retained by EHD). <br />1. Site map enclosed? YES [I 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. Ensure a copy of the ".Site Health and Safety <br />Plan° is.availableon 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 drawn <br />to scale showing location of repairs and/or replacements. If repairing a component, describe how this will be done: (If <br />pdding piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST installation Application <br />pages 4-8 as necessary for a timely plan review): <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />1root �-- <br />t <br />,. f t- + <br />+M,'�r! ` YJ - ! R «I t J ! RR+xY ,; .. aYcll tl�.Ri'+;1 t+ R t pt a R Y i•�a6 ..��,�k;Yt a y 1! <br />