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I <br /> RETROFIT OR REPAIR <br /> 1- Site map enciosed YES j I NO E I <br /> 2. Spec sheets attached for equipment to be installed YES (I NO f I <br /> 3. Description of work to be completed_ <br /> C A- <br /> 1 <br /> Descri 1-inn of Orly I- imam 2n be rtcori- <br /> 5- All equipment is State certified or approved_ YES [I N4 <br /> tI <br /> 6- Decontamination Procedures= <br /> a_ Will piping be decontaminated priorto removal? YES j I N t i <br /> b_ Identify contractor performing decontamination-- <br /> Name <br /> econtamination_Name Phone( } <br /> Address city ZiIp <br /> C* Describe method to be used for decontamination_ <br /> d_.. _..:Describe how.rinsate material wif�be-stored ons;fe prior to manifesting offsite= <br /> e_ Rinsate Hauler and permitted Treatment, Storage Disposal Facility_ <br /> i .. <br /> Hauler Flame Phone( <br /> - i <br /> 2 i <br />