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10 RETROFIT OR REPAIR 9 <br />1. Site map enclosed YES b( NO [ ] <br />2. Spec sheets attached for equipment to be installed YES NO [ ] <br />3. Description of work to be completed: <br />J2E P C A- c L- T&+E 9( M L L% FA / L E,� ih V n_ r .-C G 7"th <br />4. Description of equipment to be used: <br />� P®n_ C,CrS S <br />All equipment is State certified or approved. YES[] NO [ ] <br />Decontamination Procedures: <br />a. Will piping be decontaminated prior to removal? <br />b. Identify contractor performing decontamination: <br />Name Phone) <br />Address City <br />c. Describe method to be used for decontamination: <br />YES[] NO[] <br />Zip <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 />0A <br />