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RETROFIT OR REPAIR <br /> 1_ Site map enclosed YES [] NO <br /> 2. Spec sheets attached for equipment,to be installed YES NO[] <br /> 3. scripti¢n of work jo becompleted: , <br /> Ier:.10t.nc cava avLA ! e �� S'fl� vi s S AS WZQ be- lr-t-�Qc a <br /> r <br /> p&'0- fVW :G m 'S .W' lNiOU't-toK 4it 8-Kst+"-e p C ,c&t- �gr�Ala-(u&c. . <br /> -- s i Pwj&Va,,4,'C 1 L&L P- a- sa -tu.a.ye, JL�V civ L, <br /> 4. Description of equipment to be used: <br /> VK 33014 - 00-2., - )1&6&eM b&&r& pi o, ei-.c. d) <br /> 5. All equipment is State certified or approved. YES) NO [I <br /> 5. Decontamination Procedures <br /> a. Will piping be decontaminated prior to removal? YES [) NO [J <br /> b. Identify contractor performing decontaminatia . <br /> Name Phoned+) <br /> Address city Zip <br /> C. Describe method to be u d for decontamination: <br /> d. Describe h In to material will be stored onsite prior to manifesting offsite: <br /> e. 11 Tauler <br /> uler and permitted Treatment, Storage & Disposal Facility: <br /> me Phone} <br /> 2 <br />