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Work Order <br /> o 1210 Elko 0riue 201AF 5 Riggs qc <br /> nenito Road 6137 Edith Blud. NF 511 Nighway 213 work omen # <br /> ACT SunoyvOle? CA 94089 Es rced, CArings, CA 90670 Albuquerque, NAA 81107 Choparml, NM 88081 Proposal #48S4B-BASO P 6097224191 P 5053493250 P S1S8240164 P Date64279 <br /> 408 S48-SOS2 F 60 722-887 F SOS 3447986 F S7S 8240208 FCustomer Information Acct. Sales ManagerName: Service Request Paye <br /> Address: escription : - <br /> A athfop, CA 9=3 i ..... ........ <br /> EPAID # ..........._...._......._...__ .. <br /> . ........ ......... <br /> Main Contact: C�000 <br /> Phone : ....._....._._. . . ...........:.. <br /> Jaime Pineda 209i5&91Si ......_........-_... <br /> Secondary Contact: — --- _. _. ;.u1tIS = <br /> Phone: <br /> .-__ .. .. ............... . . .. . <br /> Materia'Is'a "ti'tEquipment - _ <br /> Supplies <br /> New Reconditioned ----- -- - <br /> Metal Poly Fiber Metal Poly Fiber Race <br /> 85-gallon overpack : .. ........... . .. .. <br /> 55-gallon closed top ---' '_- <br /> . ............. . . . . ........_ <br /> 55-gallon open top <br /> .. ......... <br /> 30-gallon closed top - � �����"` � ---- - . - --�-- - <br /> 30-gallon open top - - ._...... .. <br /> _. ... ... t..__....._..... ...__-...........j..... <br /> 20-gallon closed top � -------_-������-_... <br /> ............._...i. <br /> 20-gallon open top : ..............._..;_._......_... -......._......_,.......__._._.,-................. Services <br /> Disposal Services: <br /> 15-gallon closed top — "` <br /> --.-. Quantity Container Size Profile #/Waste Type Shipping Document # Treatment Facility15-gallon open top " - <br /> 10-gallon closed top - ' ...... <br /> ......._.... .{._..._ i. ..._ <br /> 10-gallon open top .... ��- <br /> 5- gallon closed top � _..... ._ . . . . _ ......._ <br /> __........ r <br /> 5- gallon open top -' ......... - <br /> 1 - gallon open top "' --- <br /> ...... ..... <br /> PIH Packaging ,...._ ........... <br /> _... <br /> 275-gallon tote � - . - .. <br /> I <br /> Cubic Yard Box - . .._.......-.........._,.................. ...........::...........;................................. <br /> ............ ...... ...._. <br /> . . ........_ <br /> ......._ <br /> Oft Light Tube Drum --- ----- - ... ... <br /> .. ,... ..._.< <br /> 8ft Light Tube Drum i � . .............-..... . .. . ,_......... . .. . ............ .. _... <br /> Packing Materials # Transportation Services : <br /> Vermiculite, Bag Numbar of Containers Facility/Destination <br /> Clay Absorbent, Bag <br /> . . . .. _.__... ....._.... .. . . . .... .................. ................ <br /> Bubble Wrap, Roll . .. .. .. ..._... .... .............. . . . ........._.._... <br /> .................._...._.._......_............__....... ._._...._.........._.....,. ..................._............... <br /> -.._...._.......... ............_ .. . .. ......._.. ............._ <br /> . . . ...... ... ._.. ._.... . <br /> ._................. ............ ..._.........._._ <br /> ...._ <br /> ...... .......... ..._ <br /> ....... .. <br /> Bubble Wrap Bags, Box ... <br /> DrumLiners ._.................................................,................;..._._.............................. <br /> Pallet .. ......... . .. . ........ . . . . . <br /> SuperSack Notes: <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 j <br /> Level D \ Chemist <br /> 4 ...... . . . ... _.. _ ....: <br /> Technician <br /> J <br /> Level C <br /> Level B - Onve .�.. .. <br /> ...I� .... ..... ...... .. <br /> Other. <br /> Other Materials At Notes: <br /> Customer Signature: /�� � p�_ Dat1e: <br /> ro.. _.. PRINT NAME : ! 1 ,/C, � 61 `,• �c <br />