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02/25/2005 16:37 2094683433 FIFTH FLOOR PAGE 04 <br /> RETROFIT OR REPAIR <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: Q00 LD -ZC0Q <br /> -FU 94�I tJ ET Tb REP L-4 C C- 0 tJ E- <br /> LAJ C) C) L- 0 -T- 'T- <br /> 4. <br /> T-4. Description of equipment to be used: <br /> 5. All equipment is State certified or approved. YES IL/ NO [] <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES [] NO [] <br /> b. Identify contractor performing decontamination: <br /> Name Phone( <br /> Address City —Zip <br /> C. Describe method to be used for decontamination: <br /> d. Describe how rinsate material will be stored onsite prior to manifesting offsite: <br /> 0. in ate Hauler and permitted Treatment, Storage & Disposal Facility* <br /> Hauler Name Phone(_ <br /> 2 <br />