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RETROFIT OR REPAIR <br /> 1. Site map enclosed YES j ] NO j] <br /> 2. Spec sheets attached for equipment to be installed YES (] NO (] <br /> 3. Description of work to be completed_ <br /> s1- Descri-tinn of enninment to he ssced: <br /> S <br /> b 50 410 (- - t <br /> 5_ All equipment is State certified or approved. YES j] No[] ! <br /> ! <br /> 6_ Decontamination Procedures= <br /> a_ Will piping be decontaminated prior to removal? YES [] l C? ] <br /> b_ Identify contractor performing decontamination: <br /> Name Phone( __-_)_ <br /> Address <br /> Citi <br /> G_ Describe method to be used for decontamination_ <br /> d.. Describe how finsate material will be stored onsite-prior to manifesting--offsite: <br /> i <br /> j <br /> e- Rinsate.Hauler and permitted Treatment, Storage & Disposal Facility- <br /> Hauler <br /> acilityHauler[dame Phone(_) <br /> i <br /> i <br /> 2 i <br />