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18/2005 09:01 2093433 EHE • PAGE 03 <br /> RETROFIT OR REPAIR <br /> Site map enclosed YES NO2. <br /> Spec sheets attached for equipment to be installed YES NO () <br /> Description of work to be completed: <br /> Description of equipment to be used: C Q <br /> W18 r= i4 Ci D6, 1C <br /> 5 All equipment is State certified or approved. YES ( NO ( ) <br /> 6 Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES•( 1 ) <br /> b. Identify contractor performing decontamination: <br /> Phone(Z0'tt ) <br /> AddressjTv-t cit zip <br /> C. Describe method to be usgd for de;ontaminati n: <br /> ;- WG H /O "40 fl� 11L- <br /> d. <br /> � 2�r <br /> d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br /> AAs- t0 1 <br /> 92 <br /> e. Rinsate Hauler and permitted 4Treatment, Storage & Disposal Facility: <br /> Hauler Name t4�pMZ,-24cst eJ E" phone(ROD)�,SZ - Z/4g!- <br /> 2 <br />