Laserfiche WebLink
* RETROFIT OR REPAIR <br /> 1. Site map enclosed YES K NO [] <br /> 2. Spec sheets attached for equipment to be installed YES A NO [] <br /> 3. Description of work to be completed: <br /> coao'A 0 [Cluou M&rd(0(! <br /> Q <br /> 4. Description of equipment to be used: <br /> r <br /> CK) I r hCf')e L 1f e5 <br /> )d eauin <br /> 5. All equipment is State certified or approved. YES NO <br /> 6. Decontamination Procedures: <br /> N <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 /> e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br /> Hauler Name Phone( <br /> 2 <br />