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Work Order <br /> %60 210 Elko Orive 2010 Mission Road 265 Riggs Avenue 13122 Carmenita Road 6137 Edith Blvd. HE Sl l Highway 213 Work Order # <br /> Sunnyvale, CA 94089 Escondido, CA 92029 Merced, CA 95341 Santo Fe Springs, CA 90610 Albuquerque, NM 87107 Chaparral, NM 88081 Proposal # <br /> ACT 408 548-5050 P 760 489-5600 P 209 722-4228 P 714 S4S-2191 P 505 349-5250 P 575 8240164 P Date =N <br /> 408 548.5052 F 160 4 8 9-5625 f 209 722-8228 f 114 S4S 2287 F 505 344-7986 f 575 8240208 f Ace. Sales Manager Bruce 1Mescott <br /> Customer Information Service Request Page <br /> Name Qragnnr ESP LTD <br /> Address : Description : -_ . . ......... ._.... ................. .. .. . ............ ...._..... ....... ...._..... <br /> EPA ID 1i <br /> . . .... .. . . . . <br /> . .. <br /> . . <br /> Main Contact: . .._.__ -:.... _....---UNIAZ-= C IT Tim ... .-_ _---- <br /> Phone: <br /> -. ...---... .........:.. : . . ._...._.... . . . .. . . .. ..._... . ... ............ <br /> Secondary Contact: - - - - - <br /> Phone: .. , - 'lae __. .. ..... . ..._..-_ _. . - . ...... _._._. <br /> Materials and Equipment <br /> NewReconditioned ...._._. ................................................_.... I'll -_._ I'll ....._._........__.......................... ......._.__....._......._._._........_..-_ ......_..._. ... <br /> Supplies Metal Pol Fiber Metal Poly Fiber <br /> 85-gallon overpack <br /> .. ..... > _._ ........ <br /> 55-gallon closed top . . .. .. . . ..... ..... _. _ , . . . . . . ....... <br /> 55-gallon open top _... ........_ . —. - _ .. ..... .. . . . ...... <br /> 30-gallon closed top moi , <br /> 30-gallon open top <br /> . ........ ..... ---- . .......I <br /> 20-gallon closed top ' <br /> Services <br /> 20-gallon open top ',. II <br /> I I <br /> I Disposal Services: <br /> .........................................:......_.........._ ...................._...___..........:.........._._..... <br /> 15-gallon closed top <br /> Quantityl Container Size Profile #/Waste Type Shipping Document # Treatment Facility <br /> 15-gallon open top <br /> 10-gallon closed top <br /> ._._.._._.._...._..:_.__.. ._....__._.._......_._....__.._...... _........__............._........._...._...._....__.......s....._..._...._.._....._.__...._._._._._ .........._............._.._...._........._.... ............ <br /> 10-gallon open top <br /> 5- gallon closed top - <br /> 5- gallon open top <br /> ........... ____ . �..... . ..__.._. : ........ :-. _ ._. .. <br /> 1 - gallon open top <br /> _....._.. . . -....._ ... ... ....... . <br /> PIH Packaging <br /> 275-gallon tote - ... <br /> . .._ . _._... . . <br /> Cubic Yard Bax - <br /> .... . __. {,....... _.._.. .. . .i.._ . ...._........ . . ._... <br /> 4ft Light Tube Drum <br /> 8ft Light Tube Drum <br /> _.___- . .._. . . ...._.... e.. ......_... ... . <br /> Packing Materials # Transportation Services : <br /> Vermiculite, Bag Number of Containers Facility/Destination <br /> Clay Absorbent, Bag <br /> Bubble Wrap, Roll ........... . . .. . .......... . . . . .......... <br /> ......._. . .. . .. ... .......... . . . ....._....... <br /> Bubble Wrap Bags, Box ........._.._.._.....-.......- <br /> Drum Liners i <br /> Palley <br /> SuperSack Notes: <br /> Radioactive Waste Boxes <br /> Biological Waste Boxes <br /> .....................I.._............._......,.............. <br /> Red Biological Waste Bags I Labor: Hours/Regular Hours/Overtime service Providei <br /> Personal Protective Equipment # Project Manger <br /> Level D Chemist - <br /> ... .__ __ .......... .. .. . . ............ ..I..I............. .................. <br /> Level C Technician l <br /> .......... ___ ........ .. .. . _........... .. ... . ........... . ............... <br /> ........-........._.._.............................." Driver <br /> Level 6 <br /> Other. - .. ................... .. . . ... . ....__.. <br /> Other Materials Notes: <br /> Customer Signature: Date; i <br /> .. _......_...._._._ _ ._ I ! �� <br /> PRINT NAME : <br />