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01113/2606 14:06 4640133 ENVIRONMaITAL HEALTH PAGE 03 <br /> RETROFIT i <br /> 1. Site map enclosed YES NO <br /> 2. Spec sheets attached for equipment to be installed YES NO [l <br /> 3. Description of work to be completed: <br /> -- ----- <br /> . Description of equipment to be used: <br /> & All equipment is State certified or approved. YES NO j] <br /> 6a <br /> Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES (] NW <br /> b. identify contractor performing decontamination: <br /> Name Phone( )_ <br /> ,Address City dip <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 Mauler and permitted Treatment, Storage & Disposal Facility: <br /> Hauler Name r Phone____..._.} <br />