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01/08/2014 14:44 (209) 465-4988 Henderson Maintenance Cc Page 112 <br />0 0 6-/Vl <br />LIST SYSTEM RETROFIT OR REPAIR RECEIVED <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD),j j%j <br />1. Site map enclosed? YES NOk ENVIRONMENTAL <br />2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training <br />person installing or testing any component that is repaired or replaced. Ensure a copy of the "Site Health and Safety <br />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 drawn <br />to scale showing location of repairs and/or replacements. If repairing a component, describe how this will be done. (if <br />go:inq piping, UDC's, or other UST equipment or performing tank top upgrade, use the LIST Installation Application <br />pages 4-8 as necessary for a timely plan review): <br />V FM _"irW77_7Fi 9-••. 1 <br />11 be <br />_j*_jaceq h 3§0 to utilize mic �-q -sor-for-T-1--annular.—, <br />11ID �LM=� <br />DENDUM 1! U-1- 011-- TLS-39_0q_*� <br />420 sensor -at T-2 annularwill remain. <br />aeeme(W <br />OIA sp- <br />VeRP <br />,j G poP <br />AA <br />4. List of equipment to be used (Attach manufacturers specification sheets showing third -party approval): <br />7942 Micro Sensor non-discHminaina. <br />