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RETROFIT OR REPAIR <br /> 1. Site map enclosed YES [] NOK <br /> 2. Spec sheets attached for equipment to be installed YES Pf. NO [ ] <br /> 3. Description of work to be completed: t� <br /> �EwIoVE DEL ltJ�nn►tTSD TANIL AJGE SYSMfA 1NSTAd.4. �EEDE2- nooT <br /> 1�M M. <br /> 4. Description of equipment to be used: <br /> JEEDps.aoor 1 Lg 3S0 iL Can1SOO-6 ' PGI s IrL C 12 <br /> �EEDER -door INAGNErOa>:STRIcrIJB 'PRobEs - Pee- rANK C3� <br /> VEEOi� �pT �NtERSTITIAL SEN5a2S [ PEGTANIL 3 <br /> YEkDEQ T SUMP sawsap.S PER TANK. AND Pae DISPBMSSk 9 <br /> 5. All equipment is State certified or approved. YESK NO [ ] <br /> g, pA 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 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 />