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RETROFIT-OR REPAIR <br /> 1. Site map enclosed YES [] NO [] <br /> 2. Spec sheets attached for equipment to be installed YES []. NO [] <br /> 3. Description of work to be completed: . <br /> : 1�"Ull M <br /> C) 5 0 <br /> . S� CBS <br /> 4. Description of equipment to be used: <br /> o�hO o-4 LA)/ a u <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_ ldentify contractor performing decontamination:------ <br /> Name Phone( ) <br /> Address city Zip <br /> C. Describe method to be used for decontamination: <br /> d. Describe how ririsate material vrill be stored onsite prior to manifesting offs.".:. _. <br /> e Rinsate Hauler and permitted Treatment. Storage & Disposal Facility: <br /> Hauler Name Phone% )- <br /> 2 <br />