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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 /> r` c, Cr1 rn 51--w-A � <br /> on <br /> 4. , Description of equipment to be used: <br /> b <br /> �- <br /> C�CL,, �o GL..( <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 Phoneo -0 ) Lj <br /> Address 5�� �" LJ'►�1,,, c, City ��)�(Dc ,IL)n—Zip <br /> ' <br /> C. Describe method to be 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 Name Phone( ) <br /> 2 <br />