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RETROFIT OR REPAIR <br /> 1. Site map enclosed YES�j NO [ ] <br /> 2. Spec sheets attached for equipment to be installed YES [ ] NO <br /> 3. Qpscnption of work to be completd: <br /> Y 4 <br /> 4. Descnption of equipment to be used: <br /> 5. All equipment is State certified or approved. YESX] 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 how rinsate material will be stored onsite prior to manifesting offsite: <br /> e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br /> Hauler Name Phone( ) <br />