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18/2005 09:01 2094683433 END. •. PAGE= <br /> RETROFIT OR REPAIR <br /> 1� Site map enclosed YES () NO <br /> 2. Spec sheets attached for equipment to be installed YES J NO <br /> 3. Description of work to <br /> - J ,pompleted: <br /> 4. Descnption of equipment to be used: <br /> -------------- <br /> `5. AJI equipment is State certifled or approved. YES ( NO J <br /> 6, Decontamination Procedures: <br /> a. Will piping be deco ta�rlin to prior re oval? YES ( ) NO ( J <br /> b. Identify contractor erform g deco to Ina on: <br /> Name hone`) <br /> Address City Zip <br /> C. Describe method to be used or decontamination: ^` <br /> d. Describe how rinsate material will be stored n nor to manifesting offsite: <br /> e. Rinsate Hauler and permi ed Tre tme t, S ge & Disposal Facility: <br /> Hauler Name Phone( j <br /> 2 <br />