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RECEIVED0 LN:-RNjLjvdaG H_MgH <br />AUG 3 0 2013 UST SYSTEM RETROFIT OR REPAIR <br />110°IA <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD�10Z 0 Ned <br />0 � � E � <br />Wbl fapwYas a? YES [ j NO [ j <br />(13AI30313 <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 available on .the jobsite as required by Title B. <br />S. 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 LIST equipment, or performing tank top upgrade, use the UST Installation Application <br />pages 4-8 as necessary for a timely plan review): <br />RemQyeT-anlc Ga[d sycfam and ins$a1i T 420 sensors <br />Pre -Demo secondary containment test annular- spaces at both tanks (confirm tightness) <br />Remove concrete around 2 existing 12" annular riser manwaVs and replace with 18" manways for J -box installation. <br />Post install secondary containment test annular spaces, at both tanks (confirm tightness). <br />G��er'L <br />�ppE Fa��s <br />4. List of equipment to be used (Attach manufacturers specification sheets *showing third -party approval): <br />„794390-420• VEEDER-ROOT Interstitial Sensor (Steel Tank) <br />2 <br />