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Work Order %too 210 Elka Drive 2010 Mission Road 265 Riggs Avenue 13722 Cormenito Rood 6137 Edith Blod. NE Sl1 Highway 211- work Omer # t7C,i ACTSunnymle, CA 94089 Escondido, CA 92029 Merced, CA 95341 Sonta Fe Springs, CA 90670 Albuquerque, NM 87107 Choparrol, NM 88081 Propose # 408 548-5050 P 760 4895600 P 209 722-4228 P 714 545.2191 P 505 349-5250 P S75 824.0164 P Date t `? lJIF -t 6 408 548.5052 F 760 489-5625 F 209 722.8228 F 714 545.2287 F 505 344-7986 F 575 824.0208 F Acct sales Manager Bruco VIllil Customer Information Service Request Name: "a ,- . _ . Address: 137015 ilAdiiiniey Avenue Description : ........................................................._....__........................__._................_.._.._..._......................................................_...._.............._........ LawrOP. CA 9mo I... . . ......... IF amama . .-,-a..... .. . . ... ........mama EPA ID # CA000216MI _ --- Main Contact: `hail fihadib 209415 4156 Phone: ._...._. . mala mama.. ....... ..I . ............ . . - amara. . . .. ............ Secondary Contact: " � ' Phone: .. . _ ........ . _ mama... PO # ._.. lama... a............ ... ._. ......... . . .. . ...mama . . . ..._....-_ ..........-...._._... Materials and Equipment NewReconditionad _........ma'._..............................._.._..... ................_....._...........__..._._.............--..............._....___...__............_..._.._.............._.......................'+._..............._.......... Supplies Metal Poly Fiber Metal Poly Fiber ..._................................-..................._..........................................._..............._..............._.......-...........-......................_FIR. .._...................._lama-mama.-.._........._....... 85-gallon overpack lama... ... am 55-gallon closed top ...... _lama_ _..._... . . _mama.. . . . mama.. . . ... .. _... .. . _.......... -. _. ........... . .......... 55-gallon open top alma. . . ........ . . . . .......__. . _ ......... ........_ ....... . .. . ....... . ............. alma.__-.......... s. ................. . ......... 30-gallon closed top mom a ... ,mama. mama . .............. . . . ...a... mama _ . . ..... .. . .. .. . ........... . . - mama_.. . . . - . 30-gallon open top - - ........ ....... .. .. ........ 20-gallon closed top _._ . . ....... Services 20-gallon open top ?. - - ... .a IF ..... ...ramal Disposal Services: 15-gallon closed top Quantity Container Size Profile #/WasteT a Shipping mama.. amara . ......... YP Aping Document # Treatment Facility 15-gallon open top - ... . ...... ....... ... ...._...... . . . .. mala_. . . .......... 10-gallon closed top ._lama . .._._. amara . .... _. l _......._- RI .. . ... mama.. . . . ........ ._.._... . ......... . . . t...._.. _.__... . . .. ........_ . . . ....... 10-gallon open top __.. ...... ._..1...111.._ :.-mama... .......- mama.. . .....mama.5- gallon closed top __....... . ........_ mama .._...._... . . ._..._... _.. ... ......__.... IFF._. ..... . .. ....mama. ........ . .. mama........ . ........ .. . .. ........ ............ .........,. . _.. mama 5- gallon open top . . . . ......... . . ........ mala.._- I - gallon open top - ............. ._........ : . . ... _lama .....__. mama_.. F . . ....._. . . ........... lamm . ..... I. . .. . . .. .. PIH Packaging : --- _........... ... ... ...... . . . . . . . ._....._ . 11 . . . i........ mama.- .... .. . _ IF . . ...... . . . . ... . . 275-gallon tote . .. .. .. ._......._.... . .... CubicYard Box mama_ . .. ............. . . . ........ ......... - mama mama... mama ....... mama . _ ..... ..... . . ......... ......... . ...,...... ....._.. _ . . . ....._ ......_.. Oft Light Tube Drum - -- .. alma.. .. .._..... ..... .. . , . . ..._.... ............_.. . . ............ . .. ............ Light Tube Drum " ' ---- - -- Packing Materials # Transportation Services : Vermiculite, Bag Number of Containers Faci vicestination Clay Absorbent, Bag I. .._......... . . . ... ....... .. .. mama.......... !mama...... amara_. . Bubble Wrap, Roll � . . . ...... . . . ........... . .. ... ........ . .................... ........._._..9...................... ...........a-................................................_..... . Bubble Wrap Bags, Box ...._....._..........-......................................................................................_.............................................m ama...-._..........._......... . . ... ....... ............... . :........ . Drum Liners . . .. mama . ............ . . . ......... mama ........... .. . .................... ._. . . mama Pallet .IF.. . ... . .. .. .... ....... ... . .-.... .. .. ............._............................ ...-_ SuperSack .........,........._............................._...._ Note: ....._.............._..........- ...- _.. ... ..... Radioactive Waste Boxes Biological Waste Boxes ..........._........................ IF ......................... Red Biological Waste Bags Labor: I Hours/Regular I Hours/Overtime I ServiceProvided Personal Protective Equipment # Project Man er I 1 9. .. . . _.. . .. .. .........................._. LevelD Chemist . ...................................................._..... mama... .. . ........mama ;.......... i Level C ............. .1IF .. ... . .... Technician mama .._._.... . . ........ .. . . ._-.. mama .. . . . . ....._.. '......_.. Level B mama.. . ........-mama . . mama.. Driver .......9_.... mama.. mama .......... 9 a -m-9--........FIR _lama. Other Materials # Notes: / . . . . mama. mama mama... Customer Signature:\F Date: ......................................_............_........a PRINT NAME : ' . j0- r\ �lV Vl c, j - 1 I t` c