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Jan 14 11 09:57a Reliable Petroleu 202045-8953 p.5 <br /> to 49 <br /> UST SYSTEM RETROFIT OR REPAIR <br /> (Subm minimum of 3 sets of plans&appiicatiur:s as originals will be retained by EHD) <br /> 1. Site map enclo ? YES I] NO <br /> 2. Submit copies of I QC Service Technician andfor Instakes certifmatq and all manufacturer training certificates for <br /> each person insta�ing or testing any component that is repaired or replaced. Ensure a copy of the "Site Health <br /> and Safety Pest'i available on the jobsite as required by Tide 8. <br /> 3. Detailed descripfic 1 of work to be completed. last components to be repaired or replaced and attach a diagram <br /> drawn to scale sfid wing location of repairs andfor replaosments. If repairing a component, describe how this will <br /> be done. (If addag piping, UDC's, or other UST eq " nt, or performing tank top , use the UST <br /> Installation Appli bon pages 4-8 as necessary for a timely plan review): <br /> I <br /> -- - 'V\'-xk"9� Vzzt—t— WD <br /> m t4j cu nrb Lu&--L&,e <br /> i <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> Ity <br /> 3 <br />