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SaS*EP. 17. 2003 112. 18PM FIL' "c"R CONSTRUCTION "'-110.198-7.2/4 <br />"/12/2'003 15:j; 41 4b �1: h 11- IN r�uum P_ <br />• NWt�k b� <br />RETROFIT OR REPAIR <br />t. Site map enclosed YES [I NO [r- <br />2. Spec sheets attached fbr equipment to be Installed YES [ ] NO [�' <br />3. Description of work to be completed; <br />X11 cm-�Sir. X i Mg,vy <br />.1-7 6osoas 41,..x- j hi& Tib6 <br />.e <br />LAJ <br />—4.-4a(� <br />4. Description of equipment to be used: <br />1 <br />5. All equipment is State certifled or approved. YES NO [ <br />S. Decontamipetion Procedures: <br />a. Will piping be decontaminated prior to removal? YES NO <br />b. Identify contractor performing decontarn(nation: <br />Name Fri N r#. Cd c- Phone Ib ' )_ 37 - (,,(1 S,_„ <br />Address 3(o$5 5 1 2+ 91yo city W -S zip 9,F( -q/ <br />C, Describe method to be used for decontamination; <br />?aaw 6WL ,�+sr. Zz'"aw �y Gig baa,/ di rxs� <br />Ia4�__kZ9W9 de 14Z ;u .lam *Wkn . XG !i -01Z�' 14au/ -Aat.- <br />d. Deacrfbe how rinsate material will be stored onsite prior to manifesting offsite; <br />a. Rinsate Hauler and permitted Treatment, Storage & Disposal Fac[lity: <br />Mauler Name Phone(__) <br />2 <br />