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08/18/2005 09:01 2094683413 EHD PAGE 03 <br /> RETROFIT OR REPAIR <br /> 1. Site map enclosed YES [) NO [�]� <br /> 2. Spec sheets attached for equipment to be installed YES [( NO [] <br /> 3. DeCript��f k be completed- <br /> 4. Description of equipment to be used: <br /> 5. All equipment is State certified or approved. YES NO [ ] <br /> 6. 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 /> C. Describe method to be used for decontamination: <br /> d. Describe how rinsate material will be s ed nsite or nifesting offsite: <br /> e. Rinsate Hauler and permitted Treatment. Storage & Disposal Facility: <br /> Hauler Name Phone(__) <br /> 2 <br />