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• RETROFIT OR REPAIR • <br /> _ Site rnap enclosed YES[] NO [] <br /> 2" Spec sheets attached for equipment to be installed YES []- NO [] <br /> 3- Description of work to be completed. <br /> 4_- Description of equipment to be used: <br /> -S All equipment is State cerL7ied or approved, YES(] .- <br /> 6_ - .Decontamination Procedures_. . <br /> a: . Will piping be decontaminated prior-to removal? YES [] NO[I <br /> -- :b_ ldentify:contractur performing deconts,amation_ <br /> Name PhoneL—) <br /> Address City . zip <br /> C. Describe method to be used for decontanination_ <br /> d . Describe t do j finsate material Af be stoped onsite prior to manifesting offsite;:; _ <br /> e: Rinsate Hauler and permitted Treatment, Storage& Disposal Facility <br /> Hauler. Name< Phone(_ <br /> 2 " <br />