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P <br />1 <br />RETROFIT_OR REPAIR <br />Site map enclosed YES [ ] NO [] <br />Spec sheets attached for equipment to be installed YES [] NO [] <br />Description of work to be completed: <br />C" C C\ C) n <br />4. Description of equipment to be used: <br />is c, '-A �; �' `i\A - OOb' S- <br />5. <br />5. All equipment is State certified or approved. YES"0 NO [] <br />6. Decontamination Procedures: <br />a. Will piping be decontaminated prior to removal? YES[] NO[] <br />b. Identify contractor performing decontamination: <br />Name tr fie. \y Co rpt c� c1-or'� Phone( 9-o 9j ) VA� I b33 <br />Address City ��Uc-loon zip�IS�L <br />Ij <br />C. Describe method to be used for decontamination: <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 <br />E <br />Phone <br />