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Work Order <br /> �� 210 Elko Drive 2010 Mission Road 265 Riggs Avenue 13722 Cormenito Road 6137 Edith Blvd. NE 511 Highway 213 Work Order # <br /> Sunoyvole, CA 94089 Escondido, <br /> CA 92029 Meed, CA 95341 Santo Fe Springs, CA 90670 Albuquerque, NM 87107 Chaparral, NM 88081 Proposal # � <br /> ACT 408 548-5050 P 760 4895600 P 209 722-4228 P 714 5452191 P 505 349-5250 P 575 8240164 P Date 301F18 <br /> 408 548 5052 F 760489-5625 F 209 7228228 F 714 545-2287 F 505 3447986 F 575 824-0208 F Acct. Sales Manager ^�` .Metcolt <br /> Customer Information Service Request <br /> Name: Dra9M1 ESp LTG <br /> Address: 7570 RWGdey Avenue Description : ................._....._........_..................._...._.....-................_............_......._............_........._.__._..............-.. <br /> hfhrop, CA 85330F F I F I_I..............._........... ..._.................................._....-........._........__....._.............-.._._......._._................... ........_...__...................._. <br /> EPA ID # "'1f 1 rn ;#. ,• ;.jam, 1111.__ <br /> ........... _1111... __........ F F1111 _1111... 1.111 ......... .. ................ . <br /> Main Contact: 1t; <br /> 11__11 ........_._._ <br /> Phone : <br /> Secondary Contact: F I I .__. F I I I __.I I I I 1 11 11 1 1 F F _1111 1__111. . .. ................... <br /> Phone: I I rIF _� . . j .rS <br /> IF_ .. . ...._ FF-_. . . _.. I F F ... ............... .. . _....._..... <br /> 4 _ <br /> Materials and Equipment JNA Open Top <br /> Supplies <br /> New Reconditioned 1 . ........: .. 1.111... - . . <br /> Metal Poly Fiber Meal Poly Fiber 4 HR ft Labb' r <br /> .... 1111.._. 1.1.11... _ . . . . ....... <br /> 85-gallon overpack <br /> 1EA -.r. <br /> 55-gallon closed top - - ,-� — --_ 1 1. 1 1 - ---.... . . . .. 111.1.. . . . <br /> . . ...... . -..... . 1111 . . . . . ......... <br /> ......._......... ._............ ... . . . : 1111.._ <br /> 55-gallon open top <br /> . . ............ . ..-..-1111 . 1111 1111... 1111 . 1111. 1111 . <br /> 30-gallon closed top <br /> .­.F !._...._.... ....... . ......._ <br /> 30-gallon open top <br /> 1111. . . <br /> . . .......... <br /> ......_..__.... ..._.._.._.....i..._......._._. ......._....-....4...._.............!._.............. <br /> 20-gallon closed top <br /> 20-gallon open top <br /> Services <br /> .IF <br /> " - --- - Disposal Services: <br /> I. <br /> 15-gallon Closed top quartiiTy Container Size Profile #/Waste T e Shi <br /> - - 1111.. yp Aping Docume t # Treatment Facility <br /> 15-gallon open top i/ ✓lam <br /> 9. <br /> 10-gallon closed top _ <br /> l <br /> 10-gallon open top // -- -- <br /> .... 1111. 1111. 1111 W O <br /> 5- gallon closed top --- - - - 1111 <br /> F � Ok2s is <br /> 5- gallon open top <br /> 1 - gallon open top <br /> PIH Packaging 1111... 1111..- . .. , . ...._... <br /> . . - ......._. . . 1 .111... _ - . 1111. . . . . <br /> 275-gal1 <br /> 0 <br /> n tote .. . . . . .._......._ ........... . .. ........... <br /> . . .._ ............. ... . . ......... 1111 ........ <br /> ..-1111.. ' . ..........- . . 1111. <br /> Cubic Yard Box ........ .. . ........... <br /> 1111. .. . ............ <br /> 4ft Light Tube Drum . . . :...... .. .. ............ . ._ 11.11... <br /> - 1111 111.1... <br /> Sft Light Tube Drum - .. . . . . . ........... - . . .......... . . 11 .....1_9._.. . . , <br /> Packing Materials # Transportation Services : <br /> Vermiculite, Bag Number of Containers Facility/Destination <br /> Clay Absorbent, Bag <br /> Bubble Wrap, Roll -4 - . . 1111. . <br /> L4 <br /> Bubble Wrap Bags, Box � ��� � �"' "` <br /> 1111. ... 1111 <br /> rum Liners .. <br /> Pallet U . .1111 . ...... .... . . <br /> . . 11 .... ............ ........ ....._..... 1111... <br /> SuperSack ...... Notes: <br /> .............._.......................................16.16.. <br /> Radioactive Waste Boxes <br /> ..-_.._....................... ......................... <br /> Biological Waste Boxes <br /> ..... <br /> Red Biological Waste Bags ����� �� �����_��������� ���� I Labor: <br /> Hours/Regular I Hours/Overtime Service Provided <br /> Personal Protective Equipment -# Project Manger <br /> _9111 . . . . . r ;......,. <br /> .... ... _9_911... <br /> Level D Chemist " - -- -- ----- --- <br /> ..... ........... . .!........ <br /> .......... <br /> Level C ........... Technician <br /> - --_ _......... ._........ ...... . ......... <br /> _9 <br /> Level B 111. 1111 . <br /> ..._._. 1111. . Dnver .tl^ - 1111.. _._..... ... ....... . .. <br /> r �'' ........ 1111. . . . ..... <br /> . . . .. 4—K--� 1111. j 1111.. <br /> . . 1111.. 1111... 1111. 1111. <br /> Other Materials # other. <br /> Notes: <br /> .................................... ........................ <br /> .............................._...........,................. Customer Signature: — <br /> ri <br /> Date: <br /> . ........ 1111 1111. ' <br /> � 1 - 9 _�8 <br /> PRINT NAME : - - : <br />