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RETROFIT.OR REPAIR <br /> 1. Site map enclosed YES [I NO [] <br /> 2. Spec sheets attached for equipment to be installed YES [} NO [] <br /> 3. Description of work to be completed: <br /> cru, e1`� �106 <br /> Description of enLiinmPnt to Fief tsed- <br /> P <br /> 5_ All equipment is State certified or approved_ YES [} NO j] <br /> 6. Decontamination Procedures: <br /> a. Wi11 piping be decontaminated prior to removal? YES [] NO [] <br /> b. Identify contractor performing decontamination: <br /> Name Phone(__=) <br /> Address city Zip <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 />