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Ell <br />Al <br />11 <br />Site map enclosed YES <br />REPAIRAETROFITOR <br />=V <br />Spec sheets attached for equipment to be installed YES [] NO [] <br />Description of work to be completed: <br />® i <br />INZS <br />O �,b V\ t' <br />Description of equipment to be used: <br />All equipment is State certified or approved. YESrA NO [ ] <br />Decontamination Procedures: <br />a. Will piping be decontaminated prior to removal? YES [ ] NO <br />b. Identify contractor performing decontamination: <br />Name `� 1r� 1 C' _o r c c.k-o r Phone(_ ) 1 <br />Address \ c City t ®C. _ L Zip S <br />C . Describe method to be used for decontamination: <br />"S\ m <br />d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br />`S r-\ <br />e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br />Hauler Nam\1c, Phone <br />2 <br />