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265 Riggs Avenue 12 1 U Ao 8rira 2213 Meyan ks 2581 S.6otmey Si., $site 8 <br />Merced, CA 95341 Sim pal,, CA 94889 Euondido, CA 92929 Santa A4o, CA 92787 <br />284 n2.4228 P 488 548 5858 r 768 4095688 f 714 545-2191 r <br />7897248278 t 40054858521 7684893625 r 71454522871 <br />work Order s <br />Proposal a <br />Data <br />IACco.ul sales Manager: <br />Customer Information Sewice'Request <br />Name: LdzL(' LLC dbrs VBI1MyTowing Producta Description: <br />Address: is" 13 Smith 3to*U)rl 3trodWork Orcier sr JI i4 <br />Lodi. CA 95240 <br />z: era r—•_t c a __ <br />EPA ID # CAL {jai 348 tis <br />Main contact Cody -223101281 F.--—.Vacuan Tvack.i asc -: 1096"7(1r'`.A.. <br />Phone: �(jl}.9„(�.. <br />abOr..Twk'srl)r'ipar' -"..... <br />- <br />Secondary comae: � Mr al Pr-O(cxtive F <br />Phnna� -t4LSiptStt,43t 1., rvse@iP <br />Mafllfest anfl iaefl@ratOr tR GrtnBtiQn <br />ChiOr 04oct <br />Pas <br />Fall pass <br />pH <br />Fall Retain 10 <br />-- ___ Cardainer hxtormaHon <br />Containers <br />No. Type <br />TOuI <br />quandH <br />WWlinWOU" <br />US OOT Description (include proper shipping name, Hae class and ID) <br />Non Hazardous Waste, Litltud <br />1 <br />TT <br />32W <br />t3 <br />Manifest Number 12ia10 Transporter ID No �". <br />t !'t <br />lenerator EPA ID NO <br />--__.__... __ ........._ ..___._._. <br />Dealgnated Faclity and address Aitarsarxt Umdfill R tuc;: A F �• i. <br />.. ri <br />GlAltanm Pass Acta+f <br />Livcymrre, CA 9¢551 <br />usAEPA1O# <br />state to s <br />Disposal -Services, <br />Transportation Services: <br />Manifest Number elle-. pram.# dry ia[IF <br />Narahar dr CaMnumm FarllilYfnantinMim <br />Naw <br />RacomtimOd <br />9oanYry M1cc; aUDWYtMctdpaen <br />Supplies <br />Mew PON Fiber <br />I MatOl I Poly I Fiber <br />__. _... <br />55 aflon closed top <br />_.. .. <br />_... <br />_ .. ... <br />55 -gallon open top <br />30 -gallon closed top <br />30 -gallon open top <br />15 -gallon closed top <br />15 -gallon open top <br />Labup: How Ulan HoyrY/Overf(me $4rYiee PfoV(tlad <br />5- gallon closed top <br />Fue.1 Mangan <br />..... .. _. <br />Tachnie—ronq�^�r., <br />Other: J <br />5- gallon open topOhemiai <br />275 -gallon tote <br />Naves <br />Cubic Yard Box <br />S <br />Oft Light Tubo Drum <br />Customer Signature: <br />Date: <br />Oft Light Tube Drum <br />Vermiculite, Bag <br />Clay Absorbent. Ba <br />PPE <br />