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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 [I <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 [J 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 /> d. Describe hd;v rihsate material will be stored onsite prior to manifesting offsite:-. <br /> e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br /> Hauler Name Pi7orieU_ <br /> 2 <br />