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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 /> c <br /> 4_ _E)esvr intinn of -ni timm�nt _e to ha used: <br /> r- - _ <br /> 17 <br /> S. All equipment is State certified or approved- YES i I NO [] <br /> 0. De,::on„4,.xrzina1ion Procedures: <br /> a_ WL'! piping be decontaminated priorto removal? YES <br /> b_ Identify contra,-tor perfwmincd decontamination_ <br /> NainE — — — Phone <br /> Address_— ---- --- city-- —ZIP— =-- <br /> r_ scribe method to be used for decontamination: <br /> c.i Describe how rinsate material will be stored onsite prior to rnanifestino offsite. <br /> e. Rinsate Hauler and per-Witted Treatment, Storage& Disposal Facility: <br /> Hauler Larne _ Prone( <br /> 2 - <br />