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RETROFIT"OR REPAIR <br /> 1. Site map enclosed YES (] NO [] <br /> 2. Spec sheets attached for equipment to be installed YES [] NO [] <br /> 3. Description of work to be completed: <br /> / 47 Pt <br /> 4. Description of K equipment to be used: <br /> P/' y1- he01 oboe C N l " <br /> 5_ All equipment is State certified or approved. YES [] NO [] <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated priorto removal? YES [] NO [] <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 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 />