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Work Order ATT1(1 ENI C <br /> 1210 Elko Drive 2010 Mission had 265 Rings Avenue 13722 Camera Rod 4137 Edith Bhd IIE 511 Kghay 113 work order i <br /> :.: Surtllyvale (A 94089' Iscondido,{A 92019 Merced,(A 95341 Soma f e Sp+ings,(A 90610 Albuquerque,NIA 87 i01 {haponr ,NA!8$081 Proposal s 92234 <br /> ACT` 408 5485050 P 760 484-5600 P 209 722.4228 P 714 5452191 P 505 3495250 P 575 8140164 P [late 04-MAR-16 <br /> w, 408 54850522 f 760 4895625 f 1 209122.8228 f 114 545.2287 f 505 344.1986 F 575 824-0208 f Acct.Sates Manager Hnrlry D"OSlsri <br /> Customer Information Service Request rww <br /> Name: Manteca USO! Laftop Mph Scholl <br /> Address'4!«47 W Ladm)p Rd Description: . . . --....__. <br /> Lsthm% CA 9633D _ <br /> EPA Jr)# CAL000336112 2.38-OF-BIO WASTE-1KCINERATIHW ACT25683 <br /> Main Contact:10mberfy Wi i ght 296 Q%b M 38 __...W46._ ON( j- __ <br /> Phone: 2-F/1- Bbheardous Drums <br /> 2 E*-_PeM nai.Pt[+hc*tie.Egulprtteai Lswsl U <br /> Secondary Contact: 1 -F-A-Fuel 3 Enetyy ReowaryFee-9% <br /> Phone: <br /> PO# <br /> Materiats and Equipment <br /> Supplies New Reconditioned <br /> Metal Poly Fiber Metal Poly Fiber <br /> 85-gaiion overpack <br /> 55-gallon closed top <br /> 55-gallon open top , <br /> 30-gallon closed lop <br /> 30-gallon open top <br /> 20-gallon closed top <br /> Cu9rVtCes <br /> 20-gallon open top <br /> Disposal Services: <br /> 15-gallon closed top Quardityl container Sizel Profile*/Waste Type Stripping Document I Treatment Facility <br /> 15-gallon open top <br /> lion closed top p� J <br /> 16 ad1lon open top <br /> 5-gallon closed top <br /> 5- gallon open top <br /> 1-gallon open top -- <br /> PIH Packaging <br /> t 275-gallon tote _ 1 <br /> Cubic Yard Box <br /> Oft Light Tube Drum i <br /> 8ft Light Tube Drum - — - <br /> Packing Materials # Transportation Services, <br /> Vermiculite,Bag Number of containers Facility/Destination <br /> Ciey Absorbent,Bag <br /> Bubble Wrap,Roll <br /> Bubble Wrap Bags,Box <br /> Drum Liners <br /> Pallet <br /> SuperSack Norec <br /> Radioactive Waste Boxes <br /> Biological Waste Boxes <br /> Red Biological Waste Bags Labor: Hours/Regular Hours/Ovenime Service Provided <br /> Personal Protective Equipment # Project Manger <br /> Level D Chemist <br /> Level C Technlcl? .a� r�1 <br /> LPv41 B Driver <br /> I� Other Materials # Other: <br /> .-..., customer Signature: <br /> L te: <br /> PRINT NAME: <br />