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RETRMT_OR REPAIR <br />_ Site map enclosed YES NO[] <br />2_ Spec sheets attached for equipment to be installed YES[]- NO f j <br />3_ Description of work to be completed; <br />4-- Des.cription of equipment to be used: <br />VA <br />- S_ All equipinernt is -State certWed or approved. YES <br />6_ Decontamination Procedures:. . <br />a- We01 piping be decontaminated prior- to removal? YES <br />-..:'b- ldentify:conFrac%r performing deconta�-. ma:ion._ <br />Name . PhoneC--__� <br />_ Address City Zip <br />c- Describe method to be used for decontainination; . - <br />G' 'De-senr)e naw.ifirisa!e rriaierial wiii -e sio ed onske priair ►o F'onts5 ng Qtf snE _- <br />e. Rinsate Haider acid permitted Treatment, Sfiorage &'Disposal FacsTity_ .- <br />Hauler Name <br />2 <br />