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RETROFIT OR REPAIR* <br /> 1. Site map enclosed YES [] N04 <br /> 2. Spec sheets attached for equipment to be installed YES�J NO [J <br /> 3. Description of�)york to be completed(- 1 \ <br /> 4. Description of equipment to be used: <br /> t <br /> 5. All equipment is State certified or approved. YES NO f] <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 <br /> 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 />