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RETROFIT OR REPAIR <br />1. Site map enclosed YES [ ] NO tX <br />2. Spec sheets attached for equipment to be installed YES�j NO [ ] <br />3. Description of work to be completed: <br />V-e.Ftl�cz.- � 7 sr,� ill lr�us�% <br />4. Description of equipment to be used: <br />�s a kkl l6o -- <br />5. All equipment is State certified or approved. YES M- NO [ ] <br />6. Decontamination Procedures: <br />a. Will piping be decontaminated prior to removal? YES[] NO[] <br />b: Identify eoritractor performing decontamination: <br />Name Phone( ) <br />Address <br />City <br />C. Describe method to be used for decontamination: <br />Zip <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 />