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10/25/2002 10:36 2094683433 FIFTH FLOOR PAGE 02 <br /> RETROFIT_OR REPAIR <br /> 1. Site map enclosed YES r NO [) <br /> 2. Spec sheets attached for equipment to be installed YES NO j] <br /> 3. Description of work to be completed: R yr <br /> Ar D - P. <br /> LL 1ti rC e U- zy- S . <br /> 4. Description of equipment to be used: <br /> s ,crt r%i o b l e U,�1 <br /> 5. All equipment is State certified or approved. YES * NO [I <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES NON <br /> b. Identify contractor performing decontamination: <br /> Name jr' Cc, N4,,�Phone( ) -K G / 6 3 3 7 <br /> Address 2 - 5 We 4 al x •A-- 0 v- City - ZIP 7-S-2- <br /> C. <br /> S_2-c. Describe method to be used for decontamination: <br /> `0 <br /> d. Describe how drisate material will be stored onsite prior to manifesting offsite: <br /> e. Rinsate Hauler and permitted Treatment, Storage& Disposal Facility: <br /> Hauler Name �z cz- e, s jEu t/ ;y-o 3K P.c h9ne( ��) 3 �/ '���`7 <br /> 2 <br />