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SR0086599 Love 's Travel Stop <br /> 15250 N Thornton Rd Lodi <br /> f\,l . I . 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 , UD.C'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 /> Make repairs for S-11 No Vac alarm . <br /> Fuel Pro 's conducted helium testing and isolated leak to outside 87 fill sump . <br /> > cope of work : Break out concrete next to 87 fill sump to investigate vapor return piping to find secondary leak, <br /> Up-date scope of work and equipment list once leak has been found . <br /> 6/9/23 Update Replace 1 st "secondary T"on vapor return piping - east / south est 4' from 87 fill sump <br /> 4 . List of equipment to be used (Attach manufacturer's specification sheets .showing third-party approval) : <br /> 1 ) 4" SC TEE Part # 012040-410-3 <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 />