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Work Order ATTACHMENT A <br /> +, 1210 Elko Drive 2010 Mission Road 265 Riggs Aveaue 13722 Cormenilo Road 6137 Edith Blvd BE 511 Highwoy 213 Work Order <br /> Sunnyvale,CA 94089 Escondido,CA 92029 Merced,CA 95341 Santa Fe Springs,CA 90670 Albuquerque,NM 87107 Chapanol,HM 8808 Proposal Ir <br /> ACT <br /> 408 548-5050 P 760 489.5600 P 2119122.4228 P 714 545.2191 P 505 349.5250 P 575 824-0164 P Date <br /> enoiro 406 548.5D52 F 760 489.5625 F 209 722.6228 F 714 545.2287 F505 3447986 F 515 82x-0208 F Acc(-Sales Mana�&17 <br /> 9 f H Fkwas <br /> Customer Information Service Request e <br /> rvame: MefteGill1i Urlitified Sdw)ol 01shid5letrm H <br /> Address: 17DQ ThOMSs St E Q Description: <br /> NIPF*eCi, CA$ _ ------- _ _ ....... . <br /> EPAID# CALS6 _..«....................... _...__......_...._._..._.._-------------».._.__..._.__._.__ __...___...._._._._.___.---_._......__._._. __...._..._.__....._.,_........... <br /> Main Contact: lGmb,e� VMOM -0M 1-=2Q_p <br /> Phone: 1 - -i7F-BIO WASTE-PATH-HEALTHV4W-ACT1$ggq --.-------....- <br /> Secondary Contact: — �►—'Fv£�11ifaK Poiy@H�m tfh44Hf=[ossa Tv�--------_--_ <br /> Phone-. 1 -EA-38 GWiarl Ww=rdous Drurne <br /> PO# - wpmerrt-Ltlrvpl <br /> Materials and Equipment – --- <br /> Now Reconditionett -_-- ---- - - - —_— <br /> Supplies __......_ <br /> Metal Paly Fiber Metal Poly Fiber <br /> B5-gallon overpack - - <br /> - .. .......... <br /> 55-gallon closed top .......... ._....__-...___----.--....._._.._»__._._— _— _._-•_-. <br /> 55-gallon open top --- _ --- - -- <br /> 30-gallon closed top , <br /> 313-gallon open top - <br /> i 1 <br /> 211-gallon closed top <br /> Services <br /> 211-gallon open top -J _ Disposal Services: <br /> 15 gallon Closed top 1 Quantity Container Size Profile#/Waste Type Shipping yp Aping Document# Treatment Facility <br /> 15-gallon open top <br /> allonclosed top Y__—_._-,___._ _ _�_.___». ». _.___ __._.___........... ......................... <br /> ._._....._......1-..._....._._.-'-. __ �_. _-.. I _ <br /> .-.__._..........__. ._....._._._._-._._...._ <br /> :.,-gallon open top <br /> 1� <br /> 5-gallon closed top I - - <br /> 5-gallon open top29 <br /> - - ; --- <br /> 1-gallon open top <br /> PIH Packaging ! I <br /> 275-gallon tote <br /> Cubic Yard Box i ; � -•— <br /> 4ft Light Tube Drum --......._ <br /> I <br /> Bft Light Tube Drum <br /> Packing Materials # Transportation Services: <br /> Vermiculite, Bag -- _ Number of Containers Facility/Destination <br /> Clay Absorbent, Bag <br /> -- - <br /> ..__. <br /> Bubble Wrap; Roll � I <br /> -_._._..............- — ._.... ..._«.------_............._._. -._._. _._' _.__._...._ _ _— _ .................. --.............. - -- — .._._._, ._. <br /> Bubble Wrap Bags, Box <br /> _...__._.-._._._._..... ._............_._.»....._._.._._._.--- . _......... -- -.-- - __._.___ <br /> Drum Liners ---.--. «_....__ _._._ <br /> .... <br /> Pallet _...._.___ <br /> y r t <br /> SuperSack ---- Nous: <br /> Radioactive Waste Boxes - <br /> Biological Waste Boxes <br /> ........... <br /> Red Red Biological Waste Bags Labor: Hours/Regular Hours/Overtime service Provided <br /> Personal Protective Equipment ProjectMangel• <br /> ._.....-_-_............. <br /> ___— <br /> Lever D Chemist <br /> _..._ <br /> Level C -- --- Technician (L^ --- <br /> ! _ <br /> ..........------- <br /> L-vel B Driver I _._......._ <br /> . . .._..I..__ .1"�✓.............. ._._._.._._._._. . <br /> _....._._._.-._._..._ <br /> t her: i <br /> Other Materials # Notes <br /> Customer Signature: pate. <br /> «.-..._.__............ <br /> PRINT NAME: <br />