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RECEIVED 10 0 <br />j_N9Vqj8Vd3lG HiIVBH <br />AUG 3 0 2013 UST SYSTEM RETROFIT OR REPAIR <br />Submit minimum of 3 sets of plans & applications as originals will be retained by EHDf W 0 S O (1V <br />ENVIRONME <br />tl.EA§R� f?g�*WSW? YES NO[] 03AI303IJ <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 />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 LIST Installation Application <br />pages 4-8 as necessary for a timely plan review): <br />Ramo a Tank Qard sWern and iw5tall TSI_ -300 & 2 Pa 420 sensors <br />Pre -Demo secondary containment test annular spaces at both tanks (confirm tightness) <br />Remove concrete around 2 existing 12" annular riser manways and replace with 18" manways for J -box installation. <br />Post install secondary containment test annular spaces at both tanks (confirm tightness). <br />NvVnva % P-�G Key <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />794390-420: VEEDER-ROOT Interstitia! Sensor (Steel Tank) <br />2 <br />