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RETROFIT OR REPAIR <br />1. Site map enclosed YES NO[] <br />2. Spec sheets attached for quipment to be installed YESX NO[] <br />3. Description of work to be completed: <br />4. Description of equipment to be used: <br />SU d��d 10yoto <br />5. All equipment is State certified or approved. YES/b( <br />ES NO [ ] <br />6. Decontaminatio rocedures: <br />a. Will piping be de ntaminated prior to removal? YES [ ] NO[] <br />b. Identify contractor pe ming decontamination: <br />Name ones) <br />Address / city Zip <br />i <br />C. Describe method to be used for dec n mination: <br />d. Describe how rinsate mater' I will be stored onsirior to manifesting offsite: <br />e. Rinsate Haultapermifted Treatment, Storage & Disposa acility: <br />Hauler Name Phone( ) <br />FO <br />