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RETROFIT-ORRETROFIT-OR REPAIR <br />1. Site map enclosed YES [ ] NO [] <br />2. Spec sheets attached for equipment to be installed YES [ ]. <br />3. Description of work to be completed: <br />4. Description of equipment to be used: <br />011 <br />5. All equipment is State certified or approved. YES[ NO[] <br />3 De onta ination Procedures.— <br />- <br />a. Will piping be decontaminated prior to removal? YES [ ] NO ] <br />b. Identify conttactor performing decontamination: <br />Name Phone(=_) <br />Address city Zip <br />C. Describe method to be used for de(.ontamination: <br />d. D escribe haw �nsate material will be stored onsite prior to manifesting offsite;. <br />e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br />MaulerName' r: one(__ -_moi <br />2 <br />