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40 RETROFIT OR REPAIR I* <br /> 1.' Site map enclosed YES NO <br /> 2. Spec sheets attached for equipment to be installed YES NO <br /> 3. Des ' tion of work t d:Pnp o be complete <br /> 4. Description of equipment to be used: <br /> QR n9LLA2'1-:Ac)— �ACQ-o — <br /> 5. All equipment is State certified or approved. YES NO <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES [] NO [] <br /> b. Identify contractor performing decontamination: <br /> Name Phone(_) <br /> Address City Zip <br /> C. Describe method to e uXsfor d4ta)nation: <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 Phone( <br /> 2 <br />