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RETROFIT-OR REPAIR <br /> 1- Site map enclosed YES () NO f] <br /> 2. Spec sheets attached for equipment to be installed YES [] NO [) <br /> 3_ Description of work to be completed: <br /> .p._ Description of-equinment to he imM- <br /> 5. All equipment is State certified or approved_ YES [) NO [] <br /> 6_ Decontamination Procedures: <br /> a. Will piping be decontaminated priorto removal? YFS [] NO l 1 <br /> b. Identify contractor performing decontamination: <br /> Name Phone <br /> Address <br /> c_ Describe method to be used for decontamination: <br /> d.. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br /> i <br /> e. Rinsate Hauler and permitted Treatment, Storage& Disposal Facility. <br /> Hauler Name - Phone(__—) <br /> _ , <br /> 2 <br />