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SANJ O A I I I N Environmental Health Department <br /> c_ OUNTY - - <br /> UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 3 sets of plans&applicaIIons as originals will be retained by EFI0) <br /> 1_ Site map enclosed? YES N NO [] <br /> 2_ Submit copies of IGC Service Technician andlor Installer's certificate and all manufacturer training <br /> certificates for each person installing or testing any component that Is repalred or replaced. Ensure a copy of <br /> the-Site Health and Safefy Plan" is available on the jobs ite as required by Title 8. <br /> 3. Deta-W description of work to be completed, List components to be repaired or repladed and attach ;I <br /> diagram drawn to scale shaving location of repairs andlor replacements_ If repairing a component, describe <br /> haw this will he done_ (Ir addinu piping, t_JDCE' , or other UST equipment, or performing tank top upgrade, <br /> use the UST Installation AppliWlon pages 4-8 as necessary for a firnety plan review); <br /> Flex connector replacements. No Excavation. <br /> 03120125 Replaced (4)leaking flex connectors located in Bio Shed Transition Sum} (11-2), (5)leaking <br /> flex connectors in the N. Diesel Transition $Limp (1.8)and (5) leaking flex connectors in the S. Diesel <br /> Transition Sump (11_10), <br /> 4, List or equipment to be used (Atlach manufacturers spedfication sheets showing third-party appf oval <br /> }; <br /> FraT- lin Fueling Flex Gonnectors (14),FI 3OX18E FXF-ZM <br /> -BesonUmination Procedures, <br /> a. III piping -decontaminated prior to removal? YES [] NO [] <br /> b_ Identify contractor performing decantaoaination_ <br /> Name me } <br /> Address city <br /> 3 or 6 <br />