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Feb 12 04 03: 14p Carie Brown [2091 4611-6342 p.3 <br /> RETROFITORREPAIR 3 3J17.5 <br /> - <br /> 1_ Site map enclosed YES [] NO [] ✓ `a ��J <br /> 2. Spec sheets attached for equipment to be installed YES f] NO[] <br /> 3. Description of work to be completed: <br /> pa <br /> Q, Description of equnDynent to he!4 Sed: - - <br /> 6 373S- <br /> 5_ All equipment is State certified or approved. YES[] NO[] <br /> 6. Deeontamina}Eon Procedures: <br /> a. Will piping be decontaminated prior to removal? YES f] NO i 1 <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 ansate material will be stored onsite prior to manifesting offsite: <br /> e. Rinsate Hauler and permitted Treatment, Storage& Disposal Facility <br /> Hauler Name PhoneC. <br /> I <br /> 2 <br />