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RETROFIT.OR REPAIR <br />i . Site reap enclosed YES [I NO [ j <br />2- Spec sheets attached for equipment to be installed YES [ j NO [I <br />3. Description of work to be completed: <br />DeSCrintinn of eniiinmtvnt to he I lscd: <br />r <br />►vv y (� <br />5_ All equipment is State certified or approved- YES NO [ I <br />(, Decontamination Procedures: <br />a. Will piping be decontaminated priorto removal 2 YE�z[ I NO [ <br />b Identify contractor performing decontaniiri.ition; <br />Name -- -- — -- ----PhoneL — —� — -- -- --- <br />Address _-_— _ -- tarty---- - Zip — <br />c Describe method to be used for decontarnination: <br />d. Describe how rirsate 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 />