Laserfiche WebLink
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 /> _ /-�en1GCr&/ tX/ LPa /GI)eie� � sFb`stil Z/2 0 0 q-7 1-7 <br /> r9-✓+ f,-o d��t Q 1 <br /> PLc, ciJ Vemcd-e.- ar-o4 <br /> 4. Description of equipment to be used: <br /> Zr, sl I lQol �� t L/ L✓&-111(- 1�� C-(A-6VserLc,,I � yo3btiZcy6/ <br /> Z18JAI(arf Vee /P,- /2mo4- --�em.6aY ItZU Serc4 t c/oZ <br /> 5. All equipment is State certified or approved. YES/V NO [] <br /> 6. Decontamination Procedures: / <br /> a. Will piping be decontaminated prior to removal? YES [ ] NO [ ] <br /> b. Identify contractor performing decontamination: <br /> Name Phone( ) <br /> Address City y-- 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 />