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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 [I N <br />2. <br />3. <br />Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates for each <br />Installing or on testing <br />jg any component <br />required that <br />Title repaired <br />aired or replaced. Ensure a copy of the "Site Health and Safety <br />Plan" <br />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 />addind piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST installation Application <br />Probe wires for Tank#4 unleaded and tank #5 premium <br />Will be moved from the tis -350 s/n 80951204205001 and moved to existing tls-350 <br />s/n p01230066905001 and we will also be adding balance ISD to that same monitor <br />and connecting all the flow meters and pressure sensor to it also. <br />We will be removing the existing incon tank monitor <br />s/n19080bb7 that is running the ISD at this site currently. <br />This will affect all the dispensers on the auto side and RV lanes <br />Dispenser list <br />-1/2, 3/4, 5/6, 7/8, 9/10, 11/12, 13, 14/15, 16 <br />A total of 9 dispensers and 16 fueling points <br />EH230038 (revised 12-11-15) <br />V ED <br />