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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 [] NO [I <br /> 3. Description of work to be completed: <br /> f14r� � � l ec_k �\ QclOf C)n b1 C) C� <br /> 4. Description of equipment to be used: <br /> `fK11_ � S 82d1vS�i4 <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 /> NamPhone(loc1 ) \4 1 '6231 <br /> Address 2535- ' _ wca•M City Zip 2 07' <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 /> 2 <br />