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09/01/2004 16:23 2094663433 FIFTH FLOOR PAGE 03 <br /> RETROFIT OR REPAIR <br /> 1. Site map enclosed YES/K NO [) <br /> 2. Spec sheets attached for equipment to be installed YES [} NO <br /> 3. Description of work to be completed: <br /> /t�� P L-A e E O hJ� 1���`7 VC-- <br /> LI QV t D JC-P-j `, C'2 r- `T4e F(4t I L� 5um �' Iry <br /> t�-? cJz-4--y2'2 'T-A- r-- <br /> 4- Description of equipment to be used: <br /> 5. All equipment is State certified or approved. YES/,K NO [ <br /> 5. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? J�i�/ 'r 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 stored onsite prior to manifesting offsite: <br /> e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br /> Hauler Name Phone(!_) <br /> 2 <br />