Laserfiche WebLink
RETROFIT OR REPAIR <br />1. Site map enclosed YES [ ] NO 'K <br />2. Spec sheets attached for equipment to be installed YESV NO[] <br />3. Description of work to be completed: <br />4. Description of equipment to be used: <br />5. All equipment is State certified or approved. YES f4 NO [ ] <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 City Zip <br />C. Describe method to be s d for decontamination: <br />d. Describe how rinsate materipi'will be stored onsite prior to manifesting offsite: <br />e. Rinsate Hauler end permitted Treatment, Storage & Disposal Facility: <br />Hauler Name Phone(_) <br />2 <br />