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Y <br /> RETROFITOR REPAIR <br /> 1- Site map enclosed YES NO <br /> 2- Spec sheets attached for equipment to be installed YES [] <br /> Nfl <br /> 3_ Description of work to be completed= <br /> C t` -e._. CCk <br /> c <br /> 4 0��nt�^� n#a�noii4n�rr�an�n ha sicari- <br /> r <br /> 5_ All equipment is State certified or approved_ YES [] NO �] <br /> 6- Decontarn ination Procedures= <br /> a_ Will piping be decontaminated priorto removals yES [] C <br /> b- Identify contractor performing decontamination: <br /> Name —Phone(_ <br /> Address City <br /> C_ Describe method to be used for decontamination: <br /> i <br /> d Describe hove nrisate mate iaj wilj be stored onsite prior to rnari;festing offsite- <br /> t <br /> e_ Rinsate.Hauler and permitted Treaty ant, Storage & Disposal Facitity_ <br /> Hagler Dame Phone{ <br /> k <br /> 1 <br />