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0018/2005 17: 11 20946834" FIFTH FLOOR - PAGE 05 <br /> RETROFIT OR REPAIR <br /> 1. Site map enclosed YES [c� NO [] <br /> 2. Spec sheets attached for equipment to be installed YES [] NO [] <br /> 3. Descrirtie `oto e completed: aJ 0kal- <br /> 4. Description of equipment to be used: <br /> 5. All equipment is State certified or approved. YES NO [l <br /> 6. Deco tamination Procedures: `VO�Q� v� << �'��/Z� �V) <br /> fCNO <br /> a. Will ' ing be decontaminated prior to removal? YES [] [ <br /> b. Identify con for performing decontamination: <br /> Name Phone_) <br /> Address City zip <br /> C. Describe method to be used for de tamination: <br /> d. Describe how rin sate material will be stored onsite or to manifesting offsite: <br /> e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br /> Hauler Name Phone( ) <br /> 2 <br />