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RETROFIT OR REPAIR <br /> 1. Site map enclosed YES t] NOP( <br /> 2. Spec sheets attached for equipment to be installed YES [x] NO [] <br /> 3. Description of work to be completed: <br /> "CCx (ti�.�c�V� '� .p�, <br /> �_1 } i'-"' 1 �,�l.l <br /> C /tit? v� ya Q A �'ks� , <br /> p <br /> 4. Description of equipment to be used: <br /> 61ke \A, j2eV'V4 'LAS 'tom rerCkCA A, f,OCLS <br /> 5. All equipment is State certified or approved. YES NO [] <br /> 6. Decontamination Procedures: A1/4 <br /> a. Will piping be decontaminated prior to removal? YES (] NO [] <br /> b. Identify contractor performing decontamination: <br /> Name Phone( <br /> Address city Zip <br /> C. 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 />