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RETROFIT-OR REPAIR <br /> 1_ Site map enclosed YES [] NO E <br /> 2. Spec sheets attached for equipment to be installed YES [] NO [] <br /> 3. Description of work to be completed: <br /> J <br /> Descrintinn of-nrrinmenf to he 1ised- <br /> i <br /> 5_ All equipment is State certified or approved YES [] NO (j <br /> C_ Decontamination Procedures: <br /> a_ Will piping be decontaminated priorto removals YES <br /> b- Identify contractor performing decontamination <br /> Name Phone(_ <br /> Address <br /> City —Zip— . <br /> C <br /> ip-_c: Describe method to be used for decontamination: <br /> d_ Describe how rinsate material will be stored onsite prior to manifesting offsite_ <br /> 1 <br /> i <br /> e. Rinsate Hauler and permitted Treatment,Storage& Disposal Facility-- <br /> Hauler <br /> acility_Hauler Name <br /> i <br /> i <br /> 2 <br />