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_ <br />Work Order <br />e� �� 1210 Elko Drive <br />2010 Mission Road <br />265 Riggs Avenue <br />13722 (annenito Road <br />6131 Edith Blvd. NE <br />511 Highway 213 <br />Work Order # t,? <br />fA 94089 <br />Escondido, CA 92029 <br />Merced, CA 95341 <br />Sonta Fe Springs, (A 90670 <br />Albuquerque, NM 87101 <br />(haparrol, NM 88081 <br />Proposal # 77104 <br />ACTSunnyvale, <br />408 548.5050 P <br />760489-5600 P <br />209 7224228 P <br />714 545.2191 P <br />505 349.5250 P <br />575 824-0164 P <br />Date 2:4-JUL-15 <br />408 548.5052E <br />760 4895625 F <br />209 722-8228 F <br />714 545 2287 f <br />505 3447986 F <br />575 8240208 F <br />Acct. Sales Manager &Uf.6 <br />Customer Information <br />I <br />Service Reauest <br />Name: Bmtech Rewunm Rery Englrwerlatg 1 <br />Description: <br />Address: 1820IMivabial D,._. <br />Stockton, ICA 95M <br />...... ... ......... . <br />EPA ID # NON HM <br />Main Contact: Wald Qu 209-37,0 -..��RETE.CH ii..NaE ►NA(�F� lCT23963 <br />Phone: EA- Persons) PvrDte,-:fie Equi <br />� patent-t_e*I G <br />_..1�,4—Et�alBrl:net'�yF�+aM,vTrery�as_gv,6 _. _.. . <br />Secondary Contact: <br />Phone: _......... . ..... . ...._... ....... ..... <br />PO # <br />Materials and Equipment <br />Reconditio <br />New ned <br />Supplies <br />Metal Poly Fiber Metal Poly Fiber <br />85 -gallon overpack <br />55 -gallon closed top <br />55 -gallon open top <br />30 -gallon closed top <br />30 -gallon open top <br />20 gallon closed top Services <br />20 -gallon open top Disposal Services: <br />15 -gallon closed top Quantity Container Size Profile #/Waste Type Shipping Document # Treatment Facili <br />15 -gallon open top- <br />,allon closed top <br />............... _............ ..._........... _................... ,................... ,............. <br />10 -gallon open top <br />.......... ...... ..... .........._.....................................................L................................................... <br />5- gallon closed top <br />5- gallon open top <br />1- gallon open top <br />PIH Packaging <br />275 -gallon tote <br />Cubic Yard Box <br />............... <br />4ft Light Tube Drum <br />8ft Light Tube Drum <br />Packing Materials # <br />Vermiculite, Bag <br />Clay Absorbent, Bag <br />Bubble Wrap, Roll <br />Bubble Wrap Bags, Box <br />Drum Liners <br />Pallet <br />SuperSack <br />Radioactive Waste Boxes <br />Biological Waste Boxes <br />lieu oi;,ioyicai Waste daga <br />Personal Protective Equipment # <br />Level D / <br />Level C <br />el B <br />Other Materials # <br />Number of Containers <br />Notes: <br />................................................................................................. <br />Transportation Services: <br />Facility/Desti nation <br />Labor: Hours/Regular <br />Project Manger <br />Chemist <br />Technician <br />DriverjTt., <br />Other: <br />Hours/Overtime I Service Provided <br />pores: <br />'I�21+j1L 7A=311 jo-f3U <br />Customer Signature: Date: <br />PRINT NAME: <br />