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RETROFIT OR REPAIR 10 <br /> 1 Site map enclosed YES NON <br /> 2, Spec sheets attached for equipment to be installed YES NO <br /> 3. Description of work to be completed: <br /> -z <br /> 4. Description of equipment to be used: <br /> .......... <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 Phone( ) <br /> Address ....... City Zip <br /> C. Describe method to be used for decontamination: <br /> -----------­­--­---- ---------- <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 /> Hauler <br /> £00[n IVINHNNOHIANH 11V1 TTOT9999T6 XU 9060 9009/VT/VO <br />