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' v <br /> • RETROFIT.OR REPAIR <br /> . Site map enclosed YES NOK <br /> 2 Spec sheets attached for equipment to be installed YE <br /> NO [] <br /> 3. Description of work to be completed: <br /> Ll+C-1� 56� LL vC�l� lz It1' 2 I< <br /> 4. Description of equipment to be used: <br /> 5. All equipment is State certified or approved. YES NO [] <br /> g, Decontamination Procedures: YES [] NO [] <br /> a C- W-: <br /> Will piping be decontaminated prior to removal <br /> b. Identify contractor performing decontamination: <br /> Phone(__) <br /> Name <br /> City Zip_— <br /> Address <br /> C. Describe method to be used for decontamination: <br /> d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br /> ----------------- <br /> e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br /> Phone(_.__) <br /> Hauler Name <br /> 2 <br />