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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 [ j NO [ j , <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 />Pian" is available on the jobsite as required by Title B. <br />3_ Detailed description of work :to be completed List components to .be re <br />paired.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 />addm i in UDC's or oth' UST a ui men ar. , erforrnin tank to '.0 rade; use the tJST'Installation Application <br />—3 p P 9. 9 P A 9. p p9 <br />..pages 4-8 as:necessary for a ffiim Iplan review): <br />® 1 <br />2 <br />