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WORK ORDEP <br /> 1210 Elko Drive 2213 Meyers Avenue 265 Riggs Avenue 2501 S.Garnsey St.,Suite B Work Order# <br /> T Sunnyvale,(A 94089 Escondido,(A 92029 Merced,(A 95341 Santa Ana,(A 92707 Proposal# <br /> A&C408 548-5050 P 760 489-5600 P 209 722-4228 P 714 545-2191 P <br /> 'lad Ch-111-1.1 T,m po 408 548-5052 F 760 489-5625 r 209 722-8228 F 714 545-2287 F Date 1 -j <br /> Account Sales Manager B/31Ct}VIVO 3t:ttJ! <br /> Customer Information ,, ,,. I <br /> Service Request <br /> Name: [at't3gl�;!db z 1...1 J <br /> Address:137,90 MCIOM1ey AWtn,: rDescription:......._._. <br /> f-2UFtrU% CA 96330 .........--_ _.._.._.__�_._.._.._.. _.._._......._.._. __..-- ......._.._ _...._....._....__...._.._..._.__...... _ .._....__..__.._... <br /> EPA ID# (,AL0002Wjj) - <br /> Main Contact:jl ) 0�_.. ~ <br /> Phone: 2(1"Wl"25 2-275-CYJ3 I)RIEV LATEX PAINT IN CANS-ACT1720 <br /> Secondary Contact: Or <br /> t. Ht. ._.___..._..._..___.._..___...._..__._ <br /> Phone: 1 -EA-CQWcYwd aoxw/PtA*l <br /> —- ........_...._.�-_.._....._........................._....._._._.. <br /> PO# E�'i:;°6�;JV1JT CNEL.I <br /> 1 E-A^P#A II$N-ok'A+Ae 611.... IM.a.n.I-L.vW.O ........_.........._ <br /> Materials and Equipment <br /> Supplies New Reconditioned -____..__._ —_ ___.._.________.....__....._.........---- <br /> Metal Poly Fiber Metal Poly Fiber <br /> __._......_._..__ <br /> 85-gallon overpack .........._.___.�___......_...._......___ <br /> 55-gallon closed top i ..........................._............................._.___..___. <br /> 55-gallon open top (...._....................................F........_ 1_...._.._....... <br /> . <br /> ( ....._......... ._................__..._._...__.... __..—... -- <br /> ........_......_..�._.....-__...1...................... ........... <br /> _._...._._...........--`..._...._...._..__...._........ <br /> 0-gallon closed top 1 <br /> ........... .............._.....................................__.4_...._...._..__ <br /> 30-gallon open top i i.................. .............._..._...._..........._..........._---..._...._..........................................._..__.._........................................._..........._... _ ....... <br /> ............ <br /> . <br /> .- .: <br /> 20-gallon closed top { <br /> 20-gallon open top _....;...._........_..`..........................._.._.._.................._............... Services <br /> 3..__..__.._....___...._........ Disposal Services: <br /> 15-gallon closed top i �•-••_�----._.....__.......' ' <br /> __................................' Quantit Container Size Profile#/Waste Type Shi <br /> ! +--••••- Y Aping Document# Treatment Facility <br /> 15-gallon open top i ! E <br /> _j......__.._..j-_-......_.........._ _.._• i <br /> Iallonclosed top a......... ! I i {....1 ..............................Q ........-...... ...... ._..................-......_.. <br /> !...-.................._..__._... . J p <br /> f u-gallon open top i ' � ( AS <br /> gallon closed top ; I [ �r. - t •........ ------- <br /> 5- <br /> T......._....__......... i .,+ q <br /> ........_.__..-(._......-__......,._.._._...... i—'---.... .—.._...._...._....j..S_C- • _.. k <br /> 5-gallon open top / ..._ ------- _....__ .._ _ _._._.... __......._.... <br /> ' r_ <br /> ............................_.__ .. . <br /> ---...__.. ...3...._..._..__ ..__.._....... ............... _ EE .....'.. <br /> _..t..._ ...................._..._.c_....tote ..... r--•._.......... .......___.._.. _____..__....---.___..__............._.___.__.._..__........._....--;---.._........._.._....____..__.._...-...... <br /> #----_...._._ ........ <br /> .. <br /> i 1 i <br /> ....---...-__�.......... ...__�...---..............._.._.._. : } <br /> .. .._,...-._........... ......—�.._`+.__..__....__...--___.__---• <br /> :ubic Yard Box �—._._. _-._._.--.._.._..__.. _._.... .__. _ <br /> i.-...._.----{ _...._...._ _..._.._. <br /> ._.. _._._.........._.._._.__..._.........._......__.......__....__.._.................__.._..---._..... <br /> Ift Light Tube Drum i ! <br /> aft Light Tube Drum �_. _.._... _ i-.._........._....... ....... <br /> Packing Materials # Transportation Services: <br /> /ermiculite,Bag Number of Containers <br /> .............. ..........................._.... <br /> Facility/Destination <br /> .... <br /> ;lay Absorbent,Bag A � <br /> 3ubble Wrap,Roll ................ ...__........ (1- t:ok 6 <br /> 3ubble Wrap Bags,Box NM <br /> )rum Liners 1 <br /> 'al let .....__.._...._..__....._._............ � J <br /> ! t <br /> >uperSack <br /> ..............._.......................... <br /> Notes: <br /> iadioactive Waste Boxes <br /> iiological Waste Boxes <br /> ted Biological Waste Bags <br /> Labor: Hours/Regular Hours/Overtime Service Provided <br /> Personal Protective Equipment # Project Manger 1 <br /> evel D Chemist <br /> ..............�..._........................ <br /> ! i <br /> .evel C *(41 <br /> Technician <br /> eve Driver <br /> Other Materials other: j <br /> # Notes: <br /> .} <br /> _.,.-,._........____...... Customer Signature:'4 - <br /> Date: <br /> PRINT NAME: <br /> r <br />