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RETROFIT.OR REPAIR <br /> 1. Site map enclosed YES [I NO [) <br /> 2. Spec sheets attached for equipment to be installed YES [j NO [j <br /> 3. Description of work to be completed:4. <br /> cc�rintinu of equipment in he used: . <br /> a <br /> 5_ All equipment is State certified or approved- YES [] NO [J <br /> g, Decontamination Procedures: <br /> a_ Will piping be decontaminated priorto removal? YES [] NO [i <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 stored onsite prior to manifesting offsite: <br /> e. Rinsate.Hauler and permitted Treatment,Storage & Disposal Facility: <br /> Hauler Name Phone(_ <br />