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19255517888 Main Fax GETTLER RYAN INC <br />RETROFIT OR REPAIR <br />1. Site map enclosed YES [ ] NO E] <br />2. Spec sheets attached for equipment to be installed YES [� <br />3. Description of work to be completed: <br />12:04:03 p.m. 10-26-2006 <br />(is <br />2/6 <br />4. Description of equipment tto} be used:: <br />��� `�M�� � 1' UJ \ � �.i �M� � N�IO� �L. � � yin � C." ��%b2. • �v <br />16c'r In-eN dl=5- GI I I 1 o f'j ECT - <br />12; <br />1t .1_ Viiia <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(,____) <br />Address city Zip <br />C. Describe method to be used for decontamination: <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 />2 <br />