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1 <br />2. <br />3 <br />4. <br />5 <br />n <br />09/•1212003 15:15 2094683433 FIFTH FLOOR PAGE 04 <br />Site map enclosed YES [ ] <br />RETROFIT OR REPAIR <br />NO [,I' <br />Spec sheets attached for equipment to be installed YES [I NO [� <br />Description of work to be completed: <br />�M.ovE Aw�rJ ���IA.c.E EXiSi��i co-A�-�I�.xibl� �yEZ. �-Aiiue, . <br />:17 APpEAes 44A.4- TIE LayEe �As DEEM No -N �E.D <br />L, �tN <br />Description of equipment to be used: <br />All equipment is State certified or approved. YES NO [ ] <br />Decontamination Procedures: <br />a. Will piping be decontaminated prior to removal? YES H--- NO <br />b. Identify contractor performing decontamination: <br />Name F�IINER CoNsu�oN 1N� Phone SII( <br />Address 36,33 SELL oQe+ 7ilio city Zip 956-t/ <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 />