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RETROFIT.OR REPAIR <br /> 1. Site map enclosed YES [] N'0 <br /> 2. Spec sheets attached for equipment to be installed YES.(] NO <br /> 3. Description of work to be completed: <br /> { ' IEP l-I�-C GD rn EG H _ LE f-E <br /> WPIS: VkPo9LL35 LD 2_C>00 <br /> MPJ : V0rPprZ X35 i-D2.00a 5rJ Dao VD05 030 ZIWo <br /> 'D t" Q Tit S to 14U �-t INC <br /> C&SJ\K c42-4-4-�v�► 13 0 U., (zt) 12 <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 /> i <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 />