Laserfiche WebLink
l It JV/LUC!Y 11.:JJ GV JVOOJ4JJ 1 11 Ill I LV VI\ 1 tttlL U� <br /> 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 /> gat <br /> Tj <br /> L41 <br /> J <br /> 4. Description of equipment to be used: <br /> 5. All equipment is State certified or approved. YES Fti NO [ <br /> 6. Decontamination Propedures: <br /> a. Will piping be decontaminated prior to removal? YES [] NO <br /> b. Identify contractor performing decontamination: <br /> Name (k e,! /? I A Phone( ��- <br /> Address G z--_ city 51p, Zips <br /> C. Describe method tpbe 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 NamV12 Phone_) <br /> 2 <br />