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RETROFIT-OR REPAIR <br /> {_ Site map enclosed YES[j NO [] <br /> 2- Spec sheets attached for equipment to be installed YES[]- NO[j <br /> 3_ Descry - n of work fo be completed; . <br /> j77 KA i,!12 <br /> 4-- Description of equipment to be used: - <br /> �I�L3c�6' X35 <br /> c5reA_A0, <br /> S_ Alt equip irtent:is State cerLfied or approved. ` YES[j .:. NO[j '- <br /> Decontamination Procedures=. . <br /> a_ Will:piping tie decantaminated prior-to removal? YES[j NO[] <br /> b_ ldentifj/:confractorperformingdeconta- afion:` <br /> Name PhoneC <br /> Address: City Zip <br /> C_ Describe method to be used fordecontamination_ <br /> d �eserttie fiEsAi.jif S%e material vnr A stored ohsite.ptiorto ziarges2irig offske: <br /> 7. <br /> e. FUnsate Halder and permitted Treatment,Storage 8,Disposal FacxTi[y <br /> Hauler Name Phone( — _ <br />