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Nov 05 03 03:04p CaIQCie Brown (MU 461-6342 p.2 <br />RETROFITOR REPAIR <br />I 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 />)\-L' jvw, y <br />4. Description of eauinm nt to ho I Ised: <br />C—UL—A 0 fz� <br />5- All equipment is State certified or approved- YES NO <br />-3. Decontamination Proce-;jrtfs: <br />Will piping be de-containinc*.;ed priorto removal? YES NO <br />b- Identify contractor perfor-nning decontamination: <br />Address City Zip <br />G. Describe method to be used for decontamination: <br />d- Describe how rinsate material will be stored onsite prior to manifesting offsite: <br />e. Rinsate Hauler and permitted Treatment, Storage & Disposal'Facility-" <br />Hauler Name Phone( -- <br />2 <br />