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_... __. _--- «,.,00,,,,, rir in rLuurt PAGE 04 <br /> • 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: n ' <br /> t i <br /> 4. Description of equipment to be used: <br /> Ell9 Lb Zvo <br /> 5. All equipment is State certified or approved. YESX NO [] <br /> B. Decontamination Procedures: n 1 //4 <br /> a. Will piping be decontaminated prior to removal? YES [] NO <br /> b. Identify contractor performing decontamination: <br /> Name Phone( <br /> Address city Zip <br /> C. Describe method to be used for decontamination: <br /> d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br /> e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br /> Hauler Name r Phone( ) <br /> 2 <br />