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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 [] <br /> 3_ Description of work to be,completed: <br /> Pw' t �. <br /> .4-- . Description of equipment to be used: <br /> r <br /> b- -All_equipment is-State certr-ffed or approved. YES[] NO[] <br /> 6_ Decontamination Procedures:. . <br /> a: Will piping be decontaminated prior-to removal? YES <br /> b_ ldentify:contiac-t®c performing decontdr-:�ina on- --_---- -- - - <br /> Name Phone(;] <br /> Address City Zip <br /> c. Describe method to be used for decontamination: <br /> d_ ®escriiie her a rinsa:e material vrill tie stored onsite pnorto manifesfing.ofEsite <br /> Aa Rinsate Hauler and permitted Treatment,Storage&Disposal__Facility. . <br /> Habler.Name Phone _ <br /> 2 <br />