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RETROFIT OR REPAIR <br /> 1. Site map enclosed YES b(j NO [ ] <br /> 2. Spec sheets attached for equipment to be installed YESA NO [ ] <br /> 3. Description of work to be completed: <br /> 71P/ /5 61)A-, <br /> 4. Description of equipment to be used: <br /> 5. All equipment is State certified or approved. YES NO [] <br /> 6. Decontamination rocedures: <br /> a. Will piping be deX <br /> prior to removal? YES [ ] NO [] <br /> b. Identify contractdecontamination: <br /> Name Phone(_) <br /> Address % City Zip <br /> i <br /> C. Describe method to be used for !,dn mination: <br /> d. Describe how rinsate material will be stored onsi rior to manifesting offsite: <br /> r/ <br /> e. Rinsate Hauler a permitted Treatment, Storage & Disposa acility: <br /> Hauler Name Phone( ) <br /> 2 <br />