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RETROFIT OR REPAIF . <br />1. Site map enclosed YES -A NO [] <br />2. Spec sheets attached for equipment to be installed YES A <br />3. Description of work to be completed: <br />SES 4 i i ACtcFp l,<<"SZ <br />NO [] <br />4. Description of equipment to be used: <br />OPS P►a�,sE ��C,[vT►v� oe,��R lob-� <br />5. All equipment is State certified or approved. YES <br />6. Decontamination Procedures: <br />a. Will piping be decont0ormi <br />ted prior to rem al? <br />b. entify contractor pe a inati n: <br />Name Phone <br />Address zcity <br />C. Describe method�tesed for decontamination: <br />NO [ ] <br />Zip <br />[] NO[] <br />d. Describe how rinsate M erial wi a stored onsite prior to manifesting offsite: <br />e. Rinsa Hauler and permitted Treatment, Storage & osal Facility: <br />auler Name Phone( ) <br />2 <br />