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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 [j NO [) <br /> 3. Description of work to be completed: <br /> j <br /> r�oY,Trjn. inn of Prst llnTTFPnf In ho F TCPd- - . <br /> i ^ <br /> LDi <br /> S_ All equipment is State certified or approved_ YES [j NO[j <br /> G- Decontamination Procedures= <br /> a_ Will piping be decontaminated prior to removal? YES [] NMI <br /> I <br /> b_ Identify contractor perform <br /> ing decontamination_ <br /> Blame Phone( <br /> Address <br /> City _ Z1p_ <br /> c: Describe method to be used for decontamination_ <br /> d_ - _._,Describe houv rinsate material will be stored onsite prior to manifesting offsite <br /> - I <br /> e_ Rinsate.Hauler and pennitted Treatrnent,Storage& Disposal Facility_ <br /> - i <br /> Hauler Name Phone( } i <br /> E <br /> i <br /> 2 - <br />