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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 [I <br /> 3. Description of work to be completed- <br /> nnt-on ofee IirtmPnt!n hP Itsed: <br /> i <br /> 5_ All equipment is State certified or approved- YES [] ISO [] <br /> i <br /> G_ Decontamination Procedures= <br /> a_ Will piping be decontaminated prtorlo removal? YES [] tvlE, ' l <br /> b_ Identify contractor performing decontamination- <br /> Name--- <br /> econtamination_Name __ Phone( ) <br /> Address <br /> City Zip------ <br /> c= Describe method to be used for decontamination: <br /> II <br /> Describe hove rinsate material w►ff be stored onsite pro' to manifestiriy offsite: <br /> - I <br /> - i <br /> e_ Rinsate Hauler and permitted Treatment,Storage& Disposal Facility_ <br /> Hauler[Mame Phone( <br /> 2 2 <br />