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RETROFIT -OR REPAIR <br />1. Site map enclosed YES [ ] NO [] <br />2. Spec sheets attached for equipment to be installed YES [ ] - NO [ j <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 [ ] 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 used for decontamination: <br />-t. Describe hory rinsate na aterial grill be stored onsite prior to manifesting offsitz::. <br />�- Rinsate Hauler and permitted Treatment, Storage & Disposal Facility. <br />Hauler Meme r honeL____j_ <br />