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15:ae 20946334.33 <br /> F.F7H FLOOR <br /> . � F9GF 05 <br /> RETROFIT OR 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 /> r ' �-'U L <br /> 4. Description of equipment to be used- <br /> 6. All equipment is State certified or approved. YES NO [] <br /> 6. Decontamination Procedures: <br /> a• iping be decontaminated prior to removal? YES [} NO () <br /> b. Identify con or performing decontamination: <br /> Name Pho n e(_,�) <br /> Address City Zip <br /> C. Describe method to be used for decontami 'on: <br /> d. Describe how rinsate material will be stored onsite priorto ifosting offsite: <br /> e. Rinsate Hauler and permitted Treatment, Storage & Disposal f=acility. <br /> Hauler Name Phone(- ) <br /> '1 <br /> v <br />