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RETROFIT -OR REPAIR <br />1- Site map enclosed YES� NO [] <br />2. Spec sheets attached for equipment to be installed YES NO ( ) <br />3. Description of work to be completed: <br />a -if <br />Se c <br />e -r.1 je— N Q <br />4_ escrsntinn of r?nssinrnr nt in hc? semi <br />5- All equipment is State certified or approved_ YES NO ( ] <br />G_ Decontam.-L a ion Procedures: <br />a- Will piping be decontaminated priorto removals Jai/ YES[] Mo :i <br />b_ Identity contractor performing decontamination: <br />Name —--Phoned_ <br />Address <br />— City Zip <br />C_ Describe method to b used for decontamination: <br />- IA <br />d- Describe ho ---w rinsate material will be stored onsite prior to manifesting offsite - <br />e_ Rinsate _Hau€er and permitted -Treatment, Storage & Disposal Facility: <br />Hauler Name Phone( i <br />2 <br />