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RETROFIT-OR REPAIR <br /> Site map enclosed YES J NO [j <br /> 2_ Spec sheets attached for equipment to be installed YES[}- NO [] <br /> 3_ Description of work to be,completed: <br /> -0 linh Ud hm <br /> 4-- Description of equipment to be used: <br /> : J, <br /> o ' <br /> 5. All equipment is'State cert<ied or approved. Y ES[} NO' <br /> 6. Decontamination Procedures:- <br /> a- <br /> a- rill pipinq.be decontaminated prior-to removal? YES j j NO j] - <br /> --- b_ Identify:con iac-tor perf®rming decors 6. atiorz: - - -------- -- - - <br /> - <br /> Name Phone( -) <br /> Address City Zip <br /> c. Describe method to be used for decon6mihation; <br /> Ali <br /> d_ Oescri6 ti W riiisa.e mated vall'be stoied onsite prior to inanifestirig.offsite.. - <br /> e. Rinsate Hauler and permitted Treatment,Storage&Disposal Facility_ <br /> Hauler name -Phone( <br /> 2 <br />