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Work Order <br />265 Nim Armee 1210 Bko Odve 2219 Mom Avenue 23U15.Garisay SL,SaOe a <br />Mened, CA 95341 SutayYA (A 94089 Exonchdo, CA 92024 Santo AiM, 011711 <br />209 722-1228 F 408 W-5050 a 760 4893600 P 714 5452191 r <br />* w=�= •- 204 7228228 f 408 5405as2 f 760 489.9625 f 114 5452287 r <br />Work Order If <br />Pes esai # <br />new <br />Acoa„al salmi W w, : Bridle T. <br />Customertnfomtation <br />Service Request <br />Name GRLC LLC dbe Valley Tonvingfiroducts <br />Address: 1313 So:ah Suo&ton s treat <br />EPA IDs CAL 0W 3482'78 <br />Main Contact' CDdy tIieper.....a <br />Phone. "W&M6+1 <br />Secondary Cornats; <br />Phone: <br />Po Of <br />description: w order,* 3154 <br />_. ... <br />3 —T! - Sra�zuun Truce W — 10 S7tY'A <br />i—LaharTank� Drsvze <br />I-ifQM]tlal prtY`,Cty-iVC Etpiijme.`Dr—L[:ve1 J 1111 <br />t—Fuel,@8nagyliecaveyl'ee: —3 SeiS <br />�.._ 1111 11.11 1111. . __1111 -1,111 ___1111.. <br />Manifest and Germarator Information <br />Pas. <br />Fail Pass <br />Fail Retain lD Container information <br />Chlor D4ect pH i Containers <br />US DOT Description (include proper shipping name, Haz class and to) No. ! ryAe <br />Total <br />ituamnN <br />waxbuvewaa <br />Non Hazzw*yisWasic.Ligtrid f <br />31 <br />3" <br />G <br />i <br />Manifest Number 1 it+37 1-' Tmnsportar ID No fV� C�C'Q t.Y77ii 5410 <br />_ .. _1111 ...............�..__ <br />Dcsfgnatetl Facipy antl address A?YartltYti L923C�11?+��*'..'+�J1?"4l°kn_J-04A`Y P'Y 1tt`7 <br />GonemWr EPA ro q0. <br />CAL 1,}jk} $ Z'tR <br />_ —_ _ <br />Faeiitn7 �1Ct1H� $2�.d3�-i3Dl <br />1(940AltamctitPass koa,3 <br />Livermxe, CA 94551 <br />asp Famx CAD "1382732 <br />Stam 10 e <br />Disposal Services: <br />Transportation Serves: <br />Manfest Number I She Profile# osv Tsor <br />Numberof Coniaiem r+'offaymasamatian <br />New <br />Recandilionad. <br />9uaxiN Mec. suwy De.eMtuia <br />S D lies <br />Metal Polyribs, <br />MZIJ Fiber <br />�^ <br />1111.. 1111.. 1111.. <br />55 -gallon closed top <br />_.. _1111 ...... <br />55 -gallon open top <br />30 -gallon closed [op <br />30 -gallon open top <br />15 allon closed top <br />15 -gallon open top <br />Labor- ourstRegular HoutvlOvertime Service Pmvided <br />5• gallon closed top <br />project Maaear <br />Chemin <br />Tocfee .,an <br />Ddver._l. _.G7 <br />other: <br />S. gallon open top <br />27&gallon tote <br />Nota: <br />Cubic Yard Box <br />,- _ _.. 1111 <br />Oft Light Tube Drum <br />Customer Signature: <br />Date: <br />Its Light Tube Drum <br />Vermiculite, Ba <br />Clay Absorbent, Sag <br />PPE <br />