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x/18/2005 09:01 209 433 EHD PAGE 03 <br /> RETROFIT OR REPAIR <br /> a <br /> 1- . Site map enclosed YES (j NO <br /> 2. Spec sheets attached for equipment to be installed YES ( j NO [ <br /> 3, Description of work IQ be completed: <br /> 4. Description of equipment to be used: <br /> 5. All equipment is State certified or approved. YES NO ( j <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES ( j NO [ ) <br /> b. Identify contractor/pertfrming decontamination: <br /> Name Phone(_,") <br /> Address City Zlp <br /> c. Describe method to be used for dec tamination: <br /> d. Describe how rinsate mat al will be stored onsite prior to manifesting offsite: <br /> A <br /> e. Rinsate Hauler and permitted T atment, Storage & Disposal Facility: <br /> Hauler Name <br /> 2 <br />