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19255517888 Main Fax 0 GETTLER RYAN INC 143 an. 03-12-2007 5/13 <br />1 Z44 I <br />1. Site map enclosed YES [ ] NO Z <br />2. Spec sheets attached for equipment to be installed YES ja NO <br />3. Description of work to be completed: <br />REPLACE PLLD MODULE (330374-001) FOR THE 87 & 89 TANKS. <br />ALSO IF NEED, REPLACEMENT OF PLLD & PLLD INTERFACE MODULE. <br />4. Description of equipment to be used: <br />VEEDER-ROOT PLLD MODULE (330374-001) <br />POSSIBLE REPLACING: <br />PLLD INTERFACE MODULE (PART NO. 330374-001). <br />PLLD (PART NO. 848480-001). <br />5. All equipment is State certified or approved. YES 13 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 />K <br />