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RETROFIT-OR REPAIR <br /> 11- Site map enclosed YES I J NO(] <br /> 2_ Spec sheets attached for equipment to be installed YES[]- NO [] <br /> 3_ Description of work to be completed; - <br /> O'dq �� . <br /> 4-- Description of equipment to be used: . <br /> :S- Art.equipinerif is State certified or approved= YES I .. 14G11- <br /> 6- <br /> 6 Decontamination Procedures:. . <br /> : .. a: Will piping be decontaminated prior to removal? YES[I- <br /> I <br /> j_ <br /> Identify-oonfrac�or performing decontae ation <br /> Name <br /> Address_ City` . Zp <br /> C. Describe method,to be used for decont unination::. <br /> d Descn€ie fiasnZ.ririsate maferial Vvill bee sta-ed onsite p for to umnife5iing-of _" <br /> e: FUnsate Hauler and pet nitfed Treafined,Storage&DispasaF FaaTity . <br /> Halder Name Phone( --J- <br /> .:... <br />