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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 <br /> 2. Submit copies of 1CC Service_Technician and/or: nstallers 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 /> adding 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 /> 5T P <br /> (eco ► �n pec�� a nc� ban <br /> �e � c\c� <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-partyapproval): <br /> fie C-16K <br /> 11 / .' / .. <br /> r r , f y..� 4 •( '. - 1 r::Rwrl lµ r < M' k f:: ii.1.,4 f l t _�Ht1 fry + <br /> r r It� � .k l � "1;� -� f e rt r r a ;e r � r, ; � r►}# r r M e <br /> /f+l±.. lr # q1t . V f 111 ♦. ..{�-*.'k�9.f'ts�t,w�i"I 11 /+ - 1t �1 Y r f it i�;_ �. .,...... rf '` �'.K} ir+ . <br />