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RETROFIT OR REPAIR <br /> 1. Site map enclosed YES [ j NO <br /> 2. Spec sheets attached for equipment to be installed YES NO [j <br /> 3. Description of work to be cornpleted: h <br /> VL <br /> 4. Description of equipment to be used: <br /> a r- 6 le-tL-6 ftiii' <br /> c <br /> 5. All equipment is State certified or approved. YES 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 /I <br /> Address Ci Zip <br /> C. Describe method to be used for d ntamin ion: <br /> /f <br /> d. Describe how rinsate material wi be stored on 'te prior to manifesting offsite: <br /> e. Rinsate Haeermitted Treatment, Storage & Disposal Facility: <br /> Hauler Name Phone(_) <br /> 2 <br />