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UST SYSTEM RETROFIT OR REPAIR mm IC E I V <br /> (Submit minimum of 3 sets of plans & applications as originals will be retained by EI-ID <br /> IAN $ 1022 <br /> 1 . Site map enclosed ? YES [ ] NO [ J <br /> NVIRONMENTAL HEALTH <br /> 2 . Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training, cte4 [ if�i ytestfQfip elf <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 clone. ( 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 /> Install new Phil Tite Drop Tube in Phil Tite 87 bucket due to existing drop tube is OPW <br /> 4 . List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval) : <br /> Phil Tite Defender Series <br /> 1 <br /> I <br /> EH230038 (revised 12- 11 -15) 3 <br />