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RETROFIT OR REPAIR <br /> 1: Site map enclosed YES [] NO <br /> 2. Spec sheets attached for equipment to be installed YES)o NO [] <br /> 3. Dscriptign of work to be completed:� t �t <br /> %tv � i& vt 5 s W u t <br /> e <br /> b VA -� e�usfi U4.®taijovs 4 (5-KSt+-e i CLL'CIA- tg ed wlKWkL <br /> �s-tz� �(a-t✓'® l o <br /> 'JK-4'L"W- a sa U.aye c� triad , <br /> 4. Description of equipment to be used: <br /> 5. All.equipment is State certified or approved. YES)4 NO [] <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES [] NO [] <br /> b, identify contractor performing decontaZ <br /> . <br /> Name one( _ ) <br /> Address City Zip <br /> c. Describe method to bXud r decontamination: <br /> d. Describe ho msate material will be stored onsite prior to manifesting offsite: <br /> e. 1./. Hauler <br /> te Hauler and permitted Treatment, Storage & Disposal Facility: <br /> Name Phone( ^) <br /> 2 <br />