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Work Order v5LP',� ilc 1210 Elko Olive 2010 Mission Road 265 Riggs Avenue 13722(armenita Road 6137 Edith Blvd.NE 511 Highway 213 Work Order# 141684 Sunnyvale,CA 94089 Escondido,CA 92029 Merced,(A 95341 Santo Fe Springs,CA 90670 Albuquerque,NM 87107 Chaparral,NM 88081 Proposal# ACT 408 548-5050 P 760 489.5600 P 209 722.4228 P 714 545.2191 P 505 349.5250 P 575 824.0164 P Date 23-OCT-1 enoiro 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 Pat Flares Customer Information Service Request Name: Pad of Stoddon Address: 2204 Wadhingtilsn Ave, Description: .................._..._............................._........_..............._................................_-_................._..--............................-......................... St cr,,CA 95201ACT Ddwr/Tech must cal!prior to 188%4ng the ACTyard to ensure the Port Mckl6h 6ShWa k 6 IlAhki grad In W the NWet®sfimhted® t EPA ID# CALGOMIM .......__.....tai.. ltr.,e.lte..............................._...............................................-................._._......................................._....................._._.................._....... Main Contact: Jeff Wait 20"014006 Phone: 4-56-DM-OILS!SOLIDS-1766" ................................................................. .. ......................I. ....... ...................................................................................................................... Secondary Contact: 4-66-DM-OIL.FILTERS NOT CRUSHED OR DOULRE PUNCTUREO Phone: Po# 8-EA-55Gallon Recun lllieta!Drum U 1 l�eisWl Prot E4111 ion veil Materials and Equipment •HR-Lahr-lir New Reconditioned _................-......................................-.................... ........................... ......... Supplies 1-EA-Fuel&EnergyRecArierylPae-696 OCT 2 7 2017 Metal Poly Fiber Metal Poly Fiber 85-gallon overpack _..._... ............. . ..............._.. ..__.._.._... _. _.._....... _.._.._..._. 55-gallon closed top ; I I _._.._..._.__..._...._..............................._..._......._.._ ENVIRONMENTAL HEALTH 55-gallon open top I _._.._.._......_..._..._.........__..._.._..._..........._..._._._.. __...1.._.__..._......=_......_...._......_..__..._....1 . ........................................................---..... . I3 -PARTMENT 30-gallon closed top -••---••__.r__._......._ t4..._..__._ _.._..._... 30-gallon open top _.... ._..._..._......._........................... b................t.._............. . 20-gallon closed top imod ......_._....5.„......._......i....................__.__..._.._............._' Services ..... 20-gallon open top t ............._.._.._.._..._.1._....._.__._......_.._.._..._....-......__.................... Disposal Services: 15-gallon closed top ! 1 I Quantity Container Size Profile#/Waste T_ype” 'ShippingDocu 15-gallon open top E s I ........._....b.._.._......... ......__.._........_------_ ......._....... F.................. ........... ... ............. 10-gallon closed top ; I ' ` ... .................:-------------...:_._..._..._......_._....._...s............._.....:..._.............. ... ... ......top - 10-0-gallon o 9 P P s 5-gallon closed top 5-gallon open top s _.4...............f..._..............................__........_.�..._.._........ ........ ..............t--._....._................... _._...} _......... .............. 1-gallon open top i i_.......................... I i : PIH Packaging __.__................; ............._............_...._.:_.........................._..._..1._........_._....._..._........ ......_......_....... i ........................_..._......_....................... 275-gallon tote ; ; ; �__..._...._.._.._. r...............__.:_ ....................._......;......... Cubic Yard Box __! .. ...__._. ............_....; , Y ._._. 4ft Light Tube Drum [ ! ? 8ftLight Tube Drum f............... ........................................................... Packing Materials # Transportation Services: Vermiculite,Bag Number of Containers Facility/Destination Clay Absorbent,Bag ................._.............._._....._......... .. .... Bubble Wrap,Roll _...._....._.._..._..._..._.........._.... ....._.. _..._.._.._..............._._... .._.._._.__..._.......... ..._............_................................_............._.__.._..._..._.__.._............._..........-•-........... Bubble Wrap Bags,Box ; ................................................... ............................._............ .......I..........;._.._.-..._..._..._ ....... ..._... _..... ._..._..........._..._..._..._....._...................._...._._.._.._.._..._.._...__........_..._.._....... Drum Liners .....__......._......................_.._..._.... _......_....................... ............_.._... .. Pallet ........_..._..._........... ._... ...... ...._---------_----_..._----------_......_..........._..............._........_._._. ........._._................_.......................... SuperSack Notes: Radioactive Waste Boxes Biological Waste Boxes Red Biological Waste Bags Labor: Hours/Regular I Hours/Overtime I Service Provided Personal Protective Equipment Project Manger _......_....................................._.._.............................._..._.-..._._..._..........._.._......_._._._......_..._...._.._.............._.._.-..:_._..._..._..._..._._..._._.._.................. Chemist I Level D .........._........:... ._.._........................................i..................---._._...._........_-----------i_._._................................... _..... Technician i Level C i t .._.........._ .. .. w......._._..._...._ .... ........_...._......._.................._...__......._.._..._................_.._.__,.................._......._........_................_..... ................... ......._...._..........._..._.... Drive Level B ` Other: Other Materials # Notes: ..................................................... Customer SignaturfC--,l� Date: ............................_....._............... 4� ......................._............_.............I.." PRINT NAME: