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OCT-07-2003 TUE 10:59 AMTLER RYAN FAX NO. 70 893218 P. 04 <br /> 91/25/2002 10:09 2( 3 FIFTH FLI PAGE H3 <br /> RETROFIT OR REPAIR <br /> 1. Site map enclosed YES NO [j <br /> 2- Spec sheets attached for equipment to be installed YESW NO [j <br /> 3. Description of work to be completed: <br /> M <br /> .. <br /> t t4 � <br /> 4. Description of equipment to be used. <br /> S. <br /> All equipment is State certified or approved. YES NO [ <br /> 6. Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? /A YES []) NO [] <br /> b. Identify contractor performing decontamination: /.4 <br /> Name Phone() <br /> Address <br /> City , —Zip <br /> C. Describe method to be used for decontamination: O/A <br /> d. Describe how rinsate material will be stored onsite prior to manifesting offs i ite: <br /> e. Rinsete hauler and permitted Treatment, Storage & Disposal Facility_ N/4 <br /> Hauler Name PhoneC <br /> 2 <br /> JAN 25 °02 9: 10 20846834338 PAGE .003 <br />