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! . RETROFIT.OR REPAIR <br /> 1. Site map enclosed YES [I NOW <br /> 2. Spec sheets attached for equipment to be installed YES [J NO I] <br /> 3. Description of work to be completed: <br /> dull 5&Alp-) <br /> 4. Description of equipment to be used: <br /> 5. All equipment is State certified or approved. YES [] NO [I <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES [ ] NO [] <br /> b. Identify contractor performing decontamination: /�2 <br /> Name I-, A Phone(C � 2( )'', 1 �- (0 (W�) <br /> 71 <br /> Address /IUOtAw Ok. City �I� TUV Zip -!✓OyCJ <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 />