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11 <br />Site map enclosed YES [ ] <br />IVAW&6111111 <br />im <br />Spec sheets attached for equipment to be installed YES X <br />Description of work to be completed: <br />Ll <br />MR <br />4. Description of equipment to be used: <br />C)E L)-) e(_'I'l FX P_ C) [-APj_ CQ, <br />2KI- ON Nmck- Lf, / Par qe_ <br />0 EV Dmip <br />�V� (,7)\Sc) —410 c" 12- <br />5. All equipment is State certified or approved. YES NO <br />6. Decontamination Procedures: <br />a. Will piping be decontaminated prior to removal? P I K YE_S_��� <br />b. Identify contractor performing decontamination: <br />Name k 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 />2 <br />