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265 Riggs Avenue 13722Camrmftw WORK ORDER R D E R <br /> i_. ii®m1- fe: 6212S75thA w14 Merced,CA 95341 WU Fe Springs,CA 90670 511 Highway 213 L <br /> ` c 9b]Mab utyRoad laveen,AZ85339 OnWal,NM8=1 <br /> San lose,CIt 95133 600 iom street 6137 UM Blvd NE Work order# <br /> Redlands,(A92373 Albuquerque, <br /> 408548-5050P 2010MissionRoad I136005EAmMerRwd PrOPosal# 230106 <br /> eny/lro 408548-5052F j ��G92111 4NkyneCourt,Boiiding9 208 Murray Read SE I Cbd2�'0R97015 Date nW, 03-JAN-20-20 <br /> SamateCA958D Albuquerque,NM87105 f Sales Manager Jose Ilhbran <br /> Customer Information Service Recuest Rai <br /> Name: . ,.:, �.' <br /> .,Vir�C3&�(t <br /> - Descnptlorr ,--..______ <br /> Address: <br /> �t eL�•�. R��i'iL:r:.- �.: _- <br /> -n�.... __.__...- - - .._ <br /> ,_......._—__._.— <br /> EPA ID# <br /> 4-55- -COOLANT•-1914019 <br /> Main Contact: I yC (AAfu;IA <br /> Phone: .-.......�-55 SOIL1DtESEL-1814020 <br /> Secondary Contact: 1-55- -LATEX BULK-1914278 <br /> Phone: ___ 1_GMk.- <br /> PO# 4 HR Labor-Dr1wr <br /> Materials and Equipment 7 1-EA-Wanif ist Fee <br /> New Reconditioned -•--.__3880 -EA•= fea=10%——_ —_... - ......_.. <br /> Supplies Metal Poly Fiber afetal' Poly Fiber _... <br /> 85-gallon overpack <br /> 55-gallon closed top <br /> .-------------,...__._......n......_......... <br /> ._ .._...._. <br /> 55-gallon open top <br /> 30-gallon closed top <br /> ......_.._...- <br /> 30-gallon open top <br /> 20-gallon closed top € Services <br /> _....._..... <br /> — <br /> 20-gallon open top Disposal Services: <br /> 15-gallon closed top Auantity Container Sae Profile#/Waste Type f Shipping Document# Treatment Facility <br /> 15-gallon open top zYL� <br /> 10-gallon closed top _SS Off_ <br /> +nr <br /> 10-gallon open top _ �S a! a <br /> 5-gallon closed top € , _ ._....... <br /> 5-gallon open top <br /> 1-gallon open top <br /> PIH Packaging _ —. —__...�_ _.._.._-......._._.-- <br /> ._..........:...--....._j.........._...,.._..-- .._i..__.____.�_._. _. i ___--•9 .._______i__- _.i. <br /> 275-gallon tote _ <br /> Cubic Yard Box - <br /> ---- <br /> -------- <br /> .._--..-_------:.._�_._ <br /> Oft Light Tube Drum <br /> aft Light Tube Drum <br /> Packing Materials # Transportation Services: <br /> Vermiculite,Bag <br /> Number of Cordainers Fadlity/Destination <br /> ___. _ <br /> Clay Absorbent,Bag <br /> Y � <br /> Bubble Wrap,Roll <br /> Bubble Wrap Bags,Box <br /> Drum Liners <br /> Pallet <br /> SuperSack —._�... .-. <br /> Radioactive Waste Boxes <br /> Biological Waste Boxes ...... <br /> Red Biological Waste Bags Labor: Hours/Regular Hours/Overtime Service Provided <br /> Personal Protective Equipment # Project Manger <br /> D Chemist <br /> Level <br /> -._ ..._ Technician_ - <br /> LevelC ---_..__- - •- __..__.____.____-.._._ -.._ <br /> _..�_.._ Driver _ <br /> Level <br /> Other: <br /> Other Materials # <br /> ....... _._. <br /> -,. Customer Signature- <br /> -- PRINT NAME: <br />