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Work Order <br /> =6 #0 1210 Elko Drive 2010 Mission Rood 265 Riggs Avenue 13722 Caimenito Rood 6137 Edith Blvd. NE SII Highway 213 Work order # <br /> ACTSunnyvale, CA 94089 Esmndida, CA 92029 Meed, CA 95341 Santa Fe Springs, CA 90670 Albuquerque, NM 87101 Choporml, NM 88081 Proposal # <br /> 408 548-5050 P 1fi0 489-5600 P 209 722-4228 P 714 545.2191 P 505 349 S2S0 P 575 8240164 P Date _ <br /> emyjdro <br /> 408 548.5052 F 760 489-S62S F 209 722-8228 F 714 545-2287 F 505 3447986 F 575 8240208 F Acct. Sales Manager <br /> Customer_ Information Service Request <br /> Name: DR9c:d . J:i - _ - <br /> Address: IS700 UdGdey Avenue. Description : ..-_................................ ........_............................_..__...._............................._................................. .. ...................__..a......_................F.. <br /> Lathrop, CA 95"c:s ` ..... ... ........... <br /> EPA ID # CAL00028641e ....... _. ................ ..._........ ....... .. <br /> Main Contact: Janne rineata 209415" ' <br /> Phone: - - <br /> x . ........—aaadq IF . . <br /> . . .__...... ......... <br /> Aj <br /> Secondary Contact: _ . .. . <br /> �+ e - - - - - - <br /> Phone: <br /> ___..._. ___. ................ . . .. . . ._....._.._ . .................-..... . . . . ......__... . .............. <br /> PO # <br /> ......._...................._..-........... .................. ......._...........___.........................._._....._.........._........._..:...................................__..__._......_.._...................................... <br /> Materials and Equipment <br /> New Reconditioned ...............................................................__._...-....................................._..._.........................._. ... <br /> ............. .......-d-.... ... . . . .................. <br /> Supplies Metal Pol Fiber Meal Pol Fiber <br /> 85-gallon overpack <br /> ............ <br /> 55-gallon closed top ............ ..... . . ........ . . ... ...._.. .. . ........ .... . . . . .................. . <br /> 55-gallon open top <br /> . . . . . . .. ... <br /> 30-gallon closed top <br /> ................. ............ ...... ............. ............... . . ............ . .. .........._.- <br /> 30-gallon open top <br /> . _._. ......... ..... ....,.. <br /> 20-gallon closed top <br /> ......... ......... ......... Services <br /> 20-gallon open top -; <br /> .. ............. _._. ......_....4 Disposal Services: <br /> 15-gallon closed top -, Quantityl Container Size Profile #/Waste Type Shipping Document # Treatment Facilit <br /> ....... ...... .-...... <br /> 15-gallon open top add <br /> - �l <br /> .... .......:.. <br /> 10-gallon closed top <br /> 10-gallon open top -, . . ... . . .. .. <br /> . . . . ... . ... .._... . . . . ...._... <br /> ................. . . . ............ ..... <br /> ..... ..... <br /> 5- gallon closed top ___.. ....._.._ . . .. .. .. ... .. _. . . _...._.. . . . . .._......... <br /> 5- gallon open top _ ............ . .... <br /> . _ . .. . .. ..._ .. .. . <br /> . . ..... <br /> ............. ............ ..r. . .._-.. .. <br /> ..._..- . . . . ._.....__ ......._ .. . _. . <br /> 1 - gallon open top _ <br /> ................ p........... <br /> PIH Packaging I . . . . . . . _.. ............ . . <br /> 275-gallon tote . .. .. ........... . . . . ... . <br /> . _ _ .............. . . ..._....... <br /> .. ............ _......... .1..... ......... <br /> Cubic Yard Box .. ... . . .......... . . ...... <br /> _._.. L...._ ...-.._.. .,i.__.... S. . . ............... -............ . .. .......... . ................ <br /> 4ft Light Tube Drum _- - _ -IF <br /> .............._ ...... ..._ i...... <br /> 8ft Light Tube Drum __-- <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 /> ....... . _II <br /> _ . .... ___.... .. . ._......._ . ........ <br /> Drum Liners <br /> addPalle[ mrl . . .........-. I _....._. <br /> ............................................................... <br /> SuperSack Notes: <br /> ..................................._.............._........ <br /> Radioactive Waste Boxes <br /> Biological Waste Boxes <br /> Red Biological Waste Bags Labor: Hours/RegularI Hourstovertime Service Provide) <br /> Personal Protective Equipment __#. P IF oiect Mangier <br /> Level D Chemist <br /> Level - -- Technician <br /> Level B I <br /> D ver .......... F . . .. ..._erOther Materials add Nares: <br /> Customer Signature: Date: <br /> a add <br /> PRINT NAME : <br />