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RETROFIT OR REPAIR <br /> 1. Site map enclosed YESJ,,f NO [] <br /> 2. Spec sheets attached for equipment to be installed YESK NO [] <br /> 3. Description of work to be completed: <br /> 4. Description of equipment to be used: <br /> 5. All equipment is State certified or approved. YESK NO [] <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES [ ] NO [] <br /> b. Identify contractor performing decontamination: <br /> Nam I eL ) <br /> Address City Zip <br /> c. Describe method to be ed for decontamination: <br /> d. Describ ow rinsate material will be ored onsite prior to manifesting offsite: <br /> e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br /> Hauler Name Phone(__) <br /> 2 <br />