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RETROFIT OR REPAI* <br />1. Site map enclosed YES [I NO [�]� <br />2. Spec sheets attached for equipment to be installed YES [41�_ <br />3. Description of work to be <br />13 <br />5 <br />C <br />NO [] <br />Description of equipment to be used: <br />c�lZ- <br />All equipment is State certified or approved. YES [y/ NO [ ] <br />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 ma erial w' I e stored onsite prior to manifesting offsite: <br />,�Kl <br />e. Rinsate Hauler and permitted Tre ment, Storage & Disposal Facility: <br />Hauler Name V Phone(_) <br />2 <br />