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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 NO <br /> 3. MDscn'ption 01�worlk 1�be c�omleted: <br /> Qj <br /> 4. Description of equipment to be used: <br /> 5. All equipment is State certified or approved. YES)� 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 /> e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br /> Hauler Name Phone <br /> 2 <br />