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RETROFIT OR REPAIR <br /> 1. Site map enclosed YES [] NO <br /> 2. Spee sheets attached for equipment to be installed YES [] NO <br /> 3. Description of work to be completed: <br /> K,-O-A A e -447d �► I"S <br /> 4. Description of equipment to be used: <br /> At/o <br /> 5. All equipment is State certifiedor approved. YES (] NO [] <br /> Decontamination Procedures: <br /> a. Will piping be decontaminated prior to removal? YES [I NO [] <br /> b, tify contractor performing decontamination: <br /> Name Phone( <br /> Address city Zip <br /> C, Describe method to b sed for decontamiin�00`6 <br /> "ell <br /> d. Describe how rinsate materia II be ored onsite prior to manifesting offsite: <br /> e. Rinsate Hauler`and permitted Treatment, Storage' isposal Facility: <br /> Ha Name Phone <br />