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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 /> �e bac a•�n c..la,-• s'�sa r'S on 7'`'r�ve f"an�.s" r..r� i:� kt.ac.( �/ecc�t�' 00 <br /> k4p`ace .4Z,9 on A-e/n 'f'ank Lvi to <br /> 4. Description of equipment to be used: <br /> /',•'sG 14n� 7`ocs/.r �.re� ��D r�es1�' ����me✓��'. <br /> S. 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 1 Phone <br /> Address 1ACl Zip <br /> C. Describe method to be used for dec ontamina' <br /> d. Describe how rtnsate material wi a stored onsite prior to manifesting offsite: <br /> e. Rinsate Haul e nd permitted Treatment, Storage& Disposal Facility: <br /> Haule ame Phone(_______) <br /> 2 <br />