Laserfiche WebLink
5 <br />• RETROFIT OR REPAIJBI <br />1. Site map enclosed YES &,(- NO [] <br />2. Spec sheets attached for equipment to be installed YES6 <br />3. Description of work to be completed: <br />A-4 , ACck 1�7JP Lc,-r_V- �, <br />NO [I <br />4. Description of equipment to be used: <br />5. All equipment is State certified or approved. YES -V -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 D.iLy ZiP <br />C. Describe method to be used ntamination: <br />d. D ibe how rinsate material will be stored onsite pr' to manifesting offsite: <br />e. Rinsate Hauler and permitted Treatment, Storage & Disposal Facility: <br />Hauler Name Phone( ) <br />2 <br />