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Riggs A 6511 Colorado Blvd#Z <br /> Mer95341 WORK ORDER <br /> Home Office: 6212 S 75th Avenue#4 Merced,(A 95341 Eommercerry,coeoo22 511 Highway 213 <br /> ••_. 967MaburyRoad Laveen,AZ 85339 600lowastreet 6137 Edith Blvd NE Chaparral,NM88081 Work Order# <br /> SanJose,(A95133 Redlands,CA 92373 Albuquerque,NM 87107 a r <br /> ACT`'` 408 548-5050 P 2010 Mission Road 13600 SE Ambler Road Proposal# I 5".111{y <br /> 408548-5052F ESrondWo,CA92029 Cla(kamas,OR97015 Date <br /> enVI).O 13722CarmenitaRoad 208 Murray Road SE (32-f0MA1) <br /> Santa FeSprings,CA90670 Albuquerque,NM 87105 Acct Sales Manager jorm Kiwi <br /> Customer Information Service Request <br /> Name: t4 :8b CAIR;rnia, LU., <br /> Address: 1191...0 E. Lathfa-P Road Description:__ ........ __..__._-._._.___._._____.______... <br /> Lathrop, CA�53'10 <br /> EPA ID# CAR-0001522145 <br /> 5 <br /> 5739 <br /> Main Contact: Rhfp) G atrnia M-2494,151 S01!„ 0 � <br /> _----------- <br /> Phone: 70 AC�Iard€.;T w <br /> �C:lt <br /> Secondary Contact: ii-HR Labor- A f'Mitftr Off" <br /> Phone: C. <br /> x <br /> .. � -awl __-•_ _- _-_ <br /> PO# L 1�`ka'�? I -VA �ar'�1f1i1"N'.�`r Fee <br /> . <br /> Materials and Equipment i wEA,,E:nrlyRecin,"ryFe.a <br /> New Reconditioned -'^"---- - --..--_—______.__.__.__.____.___.- <br /> Supplies Metal Poly Fiber Metal Poly Fiber <br /> 85-gallon overpack <br /> __�_..._._._...... _._._____......._..........'.................'.........__. <br /> _._._.._.__._.______._.___•_ _______.___.___...____.._.-•--------.__-___._._..._._._._........_...._..._._._._._._._-....._._._._._.__..._. <br /> 55-gallon closed top <br /> 55-gallon open top r ___._._._.._....._-_._._._._------—_____-_____—__._...._._._.___._._.___ ___ _-._.—___._.__._...._._......—........_._......_._..._. <br /> 30-gallon closed top <br /> 30-gallon open top <br /> ...._...._...... <br /> ______._..__-._-.- --__-•-• ---_._._. <br /> r r <br /> 20-gallon closed top Services <br /> 20-gallon open top <br /> Disposal Services: <br /> P <br /> 15-gallon closed top Quantity container Size Profile#/Waste Type Shipping Document# Treatment Facility <br /> 15-gallon open top i ; ... r (� _ <br /> 10-gallon closed top r <br /> 10-gallon open top — <br /> 5-gallon closed top I r <br /> 5-gallon open top <br /> _— --- - ----- — — — - ----i - _--__ __ <br /> 1-gallon open top <br /> PIH Packaging <br /> 275-gallon tote <br /> Cubic Yard Box ` <br /> 4ft Light Tube Drum <br /> 811 Light Tube Drum , �•_.____ •_._.__._. ._.-.._____C____ _.__.__._._._._. _._.__..__ ___ _,_..____..... <br /> Packing Materials # Transportation Services: <br /> Vermiculite,Bag Number of Containers FaclItty/Deslination <br /> Clay Absorbent,Bag _____.____._.____. ........._._.--------------------- <br /> -- -_._._._.__._._._._._-_.._._______...._._.C___7!'r_'� _.._._._._.._.__._._._.___.. <br /> Bubble Wrap,Roll <br /> Bubble Wrap Bags,Box <br /> Drum Liners <br /> Pallet I SuperSack Notes'. <br /> Radioactive Waste Boxes <br /> Biological Waste Boxes Red Biological Waste Bags — Labor: Hours/Regular Hours/Overtime Servlce Provided <br /> Personal Protective Equipment # Prolect Manger Level D chemistLevel C Technician._.. DriverLevel B Other: <br /> Other Materials # Notes: <br /> Customer Signature:/` J �� �, Date: <br /> PRINT NAME: (GK ` <br />