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* ** *4/07/2021 Revision to SR0083201 <br /> Billjar Valero 153 E 11 th St. Tracy, CA 95376 <br /> SANJ O A Q U I N Environmental Health Department <br /> ---- COU N T Y -- - <br /> 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 <br /> certificates for each person installing or testing any component that is repaired or replaced . Ensure a copy of <br /> the " Site Health and Safety 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 <br /> diagram drawn to scale showing location of repairs and/or replacements . If repairing a component , describe <br /> how this will be done . ( If adding piping , UDC ' s , or other UST equipment , or performing tank top upgrade , <br /> use the UST Installation Application pages 4-8 as necessary for a timely plan review) : <br /> Dispenser replacement- Install Veeder- Root ISD <br /> Removing ( 3 ) Gilbarco dispensers 4/07/2021 ** Upgrade existing Veeder- Root System for ISD . <br /> Installation of ( 3 ) Wayne Ovation dispensers <br /> Install (3) Bravo conversion frames <br /> Converting existing INCON system / Installation of new Veeder- Root / Cold start Veeder- Root <br /> 4/07/2021 ** Revise- Removing existing INCON ISD system . <br /> ** Upgrade existing Veeder- Root System for ISD . Cold start Veeder- Root . <br /> 4 . List of equipment to be used (Attach manufacturer' s specification sheets showing third -party approval ) : <br /> Attachments : <br /> Dispensers - Wayne Ovation 4/07/2021 **With factory install Veeder- Root ISD flow meters . <br /> Bravo Conversion Frames - CU250 **Veeder- Root Software Upgrade to ECPU2 Board <br /> Veeder- Root - TLS - 350 monitor system **Veeder- Root Smart Sensor Module & Pressure Sensor <br /> Veeder- Root ISD Flow meters <br /> 5 . Decontamination Procedures : <br /> a . Will piping be decontaminated prior to removal ? YES [ ] NO [ ] <br /> b . Identify contractor performing decontamination : <br /> Name Phone ( ) <br /> Address City Zip <br /> 3of6 <br />