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*I* RETROFIT OR REP* 0 <br />1. Site map enclosed YES [ ] NO <br />2. Spec sheets attached for equipment to be installed YES? NO [ ] <br />3. Description of work to be completed. - <br />77 <br />J <br />4. Description of equipment to be used: <br />TI -b'22,00 <br />I <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 />b. Identify contractor pe rfo ing decontamination: <br />Name Phone(_) <br />Address city Zip <br />Describe method t be use for deconta 'dation: <br />d. Describe how <br />will be stored onsite prior to manifesting offsite: <br />e. Rinsate H ler and permitted Treatment, Storage & Disposal Facility: <br />Hauler me Phone(_) <br />2 <br />