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Work Order 1210 Elko Drive 2010 Mission Road 265 Riggs Avenue 13722 Ccnenho Road 6137 Edith Blvd. NE Sl l Highway 213 work Order # Sunnyvale, CA 94089 Escondido, [A 92029 Merced, CA 95341 Santo Fe Springs, CA 90610 Albuquerque, NM 87107 Chapolml, NM 88081 Proposal # ACT 40854B P 760 4895600 P 209 722-4228 P 714 545-2191 P 505 349 S2S0 P 575 8240164 P Date enviro 408 548-SOS2 F 760 489.5625 F 209 722-8228 f 714 545-2281 F 505 344.7986 f 575 8240208 f Acct. Sales Manager Customer Information Service Request Name: ON¢4a : Vii' kT Address: 16 M MclGnley Avenue Description : _ ......... Lot"% CIA 9' ; .. ............. EPA ID # GAL00021164" SAKE REPLACE11AE ; e0%4 uea-^ ! - ......... ... Main Contact: Jairm Plneda I0945"156 Phone : Secondary Contact: w EA - P> r _ . Phone: . _,..._. .1,,.. ._..... ___ . . .. ... . . ............ ... .. .. .._ ___ ................. ................. .. ............. ....I..._. Materials and Equipment - NewReconditioned _..-.... .....:.m. . . .. ......... . . . .............-............-..................._............................_...._._...... Supplies Metal Poly Fiber Metal Poly Fiber 85-gallon overpack 55-gallon closed top ........ ... ............ ._ . _._.... .. .. . . ......... . . . . _..._.... .....i.. . . . - I._........... 55-gallon open top .. _... ......_._ ......_ .... .. .................. __...... ............... . . . - . ..._. . . ......_.......... . . .._.... . ... ........... 30-gallon closed top _.. ...... . ...p.. - .....-.............. ......... __. ............... . . . . . ............. _... . .. .. .. .. ... -........... . ... I . I 30-gallon open top 20-gallon closed top Services 20-gallon open top .._.._...... _._. __ .............. Disposal Services: 15-gallon closed top Quantityl Container Size Profile #/Waste Type Shipping Document # Treatment Facill 15-gallon open top . ....... t . . . _ 10-gallon closed top - _ ___- - .._.......... I. ...........-I. .. .. 10-gallon open top .. . . .. . ..... . ..... ._... 5- gallon closed top . ... ............ .. .. ........ _. . .............. _... ............ ........ . . . .i. . . 5- gallon open top ... .................. .:. . . . - . ....... .. . . .... . .. .. _.......... . ._..... . .. ..<.. ... . .. 1 - gallon open top ...... . . . . . . ... . - .. . - ..._ . . . ,. ...._....._ i...._ .. .r.. _ - PIH Packaging . . . . . . ...... . . .. . ......_. . . - . . . .............. 7....... . ._i.. . . ..........._. ._.... .. _ ....... . . 275-gallon tote . . ._ .. . ._ - . ._ ..... _. . . .. . . . . - . - . . . .........._. I. 1. . . . ..._..... . ........ . .. .. .......... Cubic Yard Box .. .. . . . ........... .......... . . . . .._._._ . ._....... _....._ . . ..;.. .._.. .. . ....... .... .._....... ............... . . . ., ........ . . . I4 ft Light Tube Drum .......... _ ...._... . . ._ ........... ............... .. . ......... ........._._.. 8ft Light Tube Drum Packing Materials At Transportation Services : Vermiculite, Bag Number of Containers Facility/Destination Clay Absorbent, Bag .. ................. . . ............. ............... .......... . ...-..... .... . .. . . ...... Bubble Wrap, Roll - _- ... . .............. . . .. ............ ....._.... ..... . . . ......+._ . . .......-.. .......... Bubble Wrap Bags, Box - �� - � Drum Liners - - �� - Pallet .. . ........:. . . . . .........._ ........ . . SuperSack Notes: Radioactive Waste Boxes ........................ Biological Waste Boxes Red Biological Waste Bas 9 9 Labor: Hours/Regular Hours/Overtime Service Provide Personal Protective Equipment # Project Mang ........ . . ... . ........_. Level D ch ist _ _-- ........... Level C ........ . .. Technician _. . Level B .... D ..... __. . ...� t ........, ....... Other: ........ .... ._I.... , .................... .........._...... Other Materials # Notes: ...............__.._........................._..... . Customer Signature:! Date: J PRINT NAME :