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RETROFIT OR REPAIR <br />1. Site map enclosed YES[] NO pt] <br />2. Spec sheets attached for equipment to be installed YES [ NO [ ] <br />3. Description of work to be completed: . <br />0 <br />4. Description of equipment to be used: <br />5. All equipment is State certified or approved. YES WO NO [ ] <br />6. Decontamination Procedures: <br />a. iping be decontaminated prior to removal? YES[] NO[] <br />b. Identify co actor performing decontamination: <br />Name Phone( ) <br />Address City Zip <br />C. Describe method to be used for ontamination: <br />d. Describe how rinsate material will be stored onsi riot to manifesting offsite: <br />e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility <br />Hauler Name Phone(_) <br />2 <br />