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11/10/2005 08:24 2094683 EHD • <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: <br />4. Description of equipment to be used: <br />Eed SackP4 aiodEj FX!I-V <br />PAGE 05 <br />5. All equipment is.State certified or.approved. YES NO[] <br />6.1. 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 />K <br />