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I I I I I I I I! p I I I I I I I 11! 111 <br />1. Site map enclosed YES f' � <br />•IMM M-17MIR 0 �4i � <br />5. All equipment is State certified or approved. YES�1=1 <br />6 <br />a. Will piping be decontaminated prior to removal? YES[] NO[] <br />b. Identify contractor performing decontamination: <br />Name PhoneC__j <br />Address city Zip <br />Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br />Hauler Name Phone( Hauler <br />Address city Zip <br />Permitted Disposal Site <br />I EEME23= <br />b. Piping Hauler <br />Name Phone <br />Address city_ Zip <br />Hauler Registration # (if hauled as hazardous) <br />c. Piping Disposal Site: <br />Name Phone <br />Address -Ci Zip_ <br />EPA lD# (if transported to a permitted TSD facili <br />!I I <br />OI== MIT112111 11117!'' ;111! 71! <br />10. Handling of excavated soil (Contaminated Soil Hazardous Waste Hauler): <br />Name Hauler Registration # Phone <br />Address city, Zip_ <br />0 <br />