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UST SYSTEM FIT OR REPAIR <br />(Submit minimum of 2 sets of plans & applications as originals will be retained by EHD) <br />1. Site map enclosed YES [ ] NO [] <br />2. Manufacturer's spec sheets attached for all equipment to be installed YES [ ] NO [ ] <br />4. Description ofequipment to be used <br />5. All equipment is State certified or approved. YES [ ] NO [] <br />a. Will piping be decontaminated prior to removal? YES [ ] NO[] <br />b. Identify contractor performing decontamination: <br />Name Pune( ) <br />Address city 2p <br />c. Describe method to be used for decontamination: <br />Storagee. Rinsate Hauler and pennitted Treatment Disposal <br />Hauler Name PhoneC__)_Hauler Reg#_ <br />Address <br />Permitted fi .. h- <br />7. a. Describe the method that will be utilized to purge and/or inert the piping: <br />b. Piping Hauler. <br />Name Phone (T, <br />Address city Zip <br />Hau r Registration # (if hauled as hazardous) <br />c. Piping Disposal <br />Name Phone <br />Address -City- zip - <br />EPA 1D# (if transported to a permitted TSD facEy)_ <br />r _ • . c • .-..ill . . i.r. <br />r, Handling. Hazardous <br />Registrabon <br />Address <br />.hauled, describe what will be done with it <br />