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y <br /> " RETROFIT-OR REPAIR <br /> =` Site map enclosed YES [] NO e v ; C' 't s S J+t <br /> �h Spec sheets attached for equipment to be installed YES [] NO [] <br /> Tfei/� <br /> 3. Description of work to be completed: o �O_ = �z y• ,?oP <br /> % 'S - 3 S— U <br /> S S o e ��' c-C /a <br /> 4. Description of equipment to be used; <br /> /2, <br /> a �P... o. e. S Qin c4. o of c c .....?M o >, ! o r S' <br /> -s 5 <br /> 5. All equipment is State certified or approved. YESA NO [] <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES [] N <br /> b. Identify contractor performing decontamination: <br /> Name �,��e �v N ^o a�v� Phone o <br /> Address 2 �S� ItI, q city <S / Zip <br /> C. Describe method to be used for decontamination: <br /> /e -e -e -v. 'L Af a <br /> d. Describehow,rinsate material will be stored onsite prior to manifesting offsite: <br /> e. Rinsate Hauler and permitted Treatment, Storage & Disposal.Facility: <br /> Hauler Namef t o_ '-L71 V v-��,e��,Phone( .s 4 7 <br /> 2 _ I <br />