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Jan 09 03 11 : 20a Caoie Brown (209) 461 -6342 P. 2 <br /> RETROFIT.OR REPAIR <br /> 5� � C► 14\A <br /> 1. Site map enclosed YES [] NO [I <br /> 2. Spec sheets attached for equipment to be installed YES [] NO [] <br /> 3. Description of work to be completed: <br /> <,W OOOp -) �-iJ� tS `i 0oV=� o <br /> 4. Description of eauinment to be used: <br /> h � Z `1 \ -001 ^ <br /> I Qtti 006 - 5 <br /> 5. All equipment is State certified or approved_ YES (74 NO [J <br /> g_ Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES [] NO [] <br /> b. Identify contractor performing decontamination: <br /> Name` l Vg Q Phone(_C1)k-b l ` 6337 <br /> Address city a >1 Zip�_Ss <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 Phone ) <br /> 2 <br />