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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 [ ] NO [ ] <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 8 . <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 UST Installation Application <br /> pages 4-8 as necessary for a timely plan review) : <br /> Remove 91 grade 3 gallon spill container, replace with 5 gallon spill container <br /> 4 . List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval ) : <br /> OPW 1C-2100C-DVR <br /> L <br /> AY 1 0 <br /> zSI . 4 <br /> EH230038 (revised 12-11A5) 3 <br />