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0 <br /> RETROFiT,O <br /> R REPAIR <br /> � Site map enclosed YES [I NO <br /> 2. Spec sheets attached for equipment to be in <br /> YES } NO <br /> 3. Description of work to be completed: <br /> 7 4- <br /> 4, Description of equipment to be used: a E r <br /> V" <br /> 5. All equipment is State certified or approved. YES NO } <br /> g, Decontamination Procedures: YES [} NO [] <br /> a Will piping be decontaminated prior to removal? <br /> b, identify contractor performing decontamination: <br /> PhoneL--�--) <br /> Name Zip <br /> City <br /> Address <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 /> Phone( ) <br /> Hauler Name <br /> 2 <br />