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-Jul 07 06 09: 45a Jeffrey C. Henley 714-7''g- 1499 P. 10 <br /> 1 <br /> RETROFIT OR REPAIR <br /> 1. Site map enclosed YES NO [ ] <br /> 2. Spec sheets attached for equipment to be installed YES [ ] NO [ ] <br /> 3. Deschtion of work to be completed: c-� x <br /> �t'�� <br /> 4. Description of equipment to be used: <br /> 5. All equipment is State certified or approved_ YES ( ] NO <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? ,� /p- 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. <br /> econtamination: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 N —Phone(�� <br /> 2 <br />