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RETROFIT -OR REPAIR <br />_ Site map enclosed YES [ ] NO[] <br />2_ Spec sheets attached for equipment to be installed YES[]- <br />3- <br />ES[]_3_ Description of work.to be. cornpleted: <br />4-- Description of equipment to be used: <br />NO[] <br />-? IU) = <br />5_ All. equipment is State certified or approved_ YES [ ] NO[] <br />6 Decontamination Procedures:. . <br />a- Will piping be decontaminated prior- to renoval? YES [ ] NO [] <br />b_ tdentify:contrac%r performing decontamination: --------.— -- -. - <br />Name . Phone( } <br />Address City Zip <br />C- Describe method to be used for decontamination <br />d'_ Describe hdV rih:sate material vallbe stores# onsite prior to manifesting. offsite= <br />e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility. - <br />Hauler Name Phones <br />2 <br />