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RETROFIT OR REPAIR <br /> 1. Site map enclosed YES [] NO)( <br /> 2. Speer sheets attached for equipment to be installed YES)(] NO [] <br /> 3. DgscriptiOn gf work o be completed: <br /> -7ecAntciais owt StujZ- Si&- oia Ty r�tus wZQ be LtlsM(!u q a_-(yt <br /> oagow ,�)11n b/¢ to e>kjst1 UC, 1M OU� fo4S f 6� 6�Sl��1 d l0.1 �K Cd U.tLt_L onccm <br /> -rVG ik1VW&4,,'Ln w Oji ITgM-Er- a. So�-tttaV-6 Ua�, Verde, <br /> 4. Description of equipment to be used: <br /> V \\ <br /> K 33014 q — (!)0-(!)0-)- G C <br /> 0 �azc Yl&6vvl bmayll- (Piero�e ei-Cited ) <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 decontaminatio . <br /> Name Phone( <br /> Address City Zip <br /> C. Describe method to bXud r decontamination: <br /> d. Describe ho Knate Material will be stored onsite prior to manifesting offsite: <br /> e. nsate Hauler and permitted Treatment, Storage & Disposal Facility: <br /> Hauler Name Phone(!_) <br /> 2 <br />