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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 [j- NO [] <br /> 3- Description of work to be_completed: <br /> 4- - Description of equipment to be used: <br /> -5- -All equipment is State p&h&d or approved, YES[j Not] - - <br /> 6- Decontamination Procedures _ <br /> a- Will piping be decontaminated prior-to removal? YES[] NO <br /> b_ Identify-iEbn raetor performing decontami atiom - _—_-:– -- -. <br /> Name Prone{ <br /> Address City Zip <br /> C_ Describe method to be used fordecontarnination: <br /> G_ uesmbe i w,ni[jacY ma enalwill v_sW;E:u uphots to [it'll icsraMt�_GuauE_ <br /> e_ Rinsate Hauler and permitted Treatment, Storage&Disposal_Facility . <br /> Hauler Name Prone{ } <br /> 2 - <br />