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Work Order <br /> 00 1210 Elko Drive 2010 Mission Rood 265 Riggs Auewe 13722 (ormenim Raad 6137 Edith Blvd. NE Sl l Highway 213 Work Order # 171201 <br /> • OF Sunnyvale, CA 94089 Escondido, CA 92029 Merced, (p 95341 Sonto fe Springs, (A 90670 Albuquerque, NM 87107 ChoporcolI NM 88081 Proposal # atJG1a <br /> ACT 408 548 5050 F 760 489-5600 P 209 722-4228 P 714 545.2191 P SDS 349-5250 P 575 8240164 P Date 13nlce Walcott <br /> enviro 408 548 5052 f 160 489-5625 F 209 7228228 F 714 5 45-22 87 f SDS 344-7986 F 575 8240208 f Acct. Sales Manager Page <br /> Cu�W6,[nformation Service Request <br /> Name: ika� <br /> Address: 15700 Md(idey Avenue Description : 9 99 9......-_......................... ..... ........ - ......... _..........I.............._._........................._.....9999 <br /> Laftli , CA 85330 <br /> ... . . . . . . ........... __9999 ................ . _,. ... ....._._ . . ............. . . .. ... . . ......... . ......_... <br /> EPA ID # CAL00028648! 10 55 # I30690D: sKAMNW%VTM DEBRf3 � <br /> Main Contact: Jail Pined& 20845"156 070176"., <br /> _. _. . ................ 9.999 .. ......._... .... ............... FF-........ ...._._ ... ..................._...... <br /> Phone: 3 - 275 - - . _ <br /> Secondary Contact: .. .....1..r.EA--. .9999... - IMF,Lav& @ . . ........ . .. . 9999. <br /> Phone: 3 HR -. <br /> MCKNFrCIL 1 EA-F <br /> f1 ®a . 1. <br /> PO # <br /> .. I IF I . 9999._. . ............... . 9__99.9 . 9 999..........._........_............_ <br /> Materials and Equipment <br /> Supplies New Reconditioned ............. . . .......I.. ._ . .. . .............._........._._......._................... <br /> ........................ <br /> Metal Poly Fiber Metal Poly Fiber <br /> _........ -............. ......... 9999.... ._........................ ............. .. . . . <br /> 85-gallon overpack <br /> 9999.. .__ ........_. <br /> 9999.. 9999 9.9.99.. . . ............................. 9 ............ . . _......... . . . . . <br /> 55-gallon closed top <br /> ...........c �._.........._ .._._ ___........ <br /> 55-gallon open top 9999 ..................999..._ _ . ... __. . <br /> .. _9999... ........._ ........._ <br /> 30-gallon closed top <br /> ... ........... ..._...... 9999 . ....... .... . . - 999 .9 . .._ _9999 .......... .... .. ._....... . ... 9_999 <br /> 30-gallon open top <br /> 20-gallon closed top ... .... ................... Services <br /> 20-gallon open top <br /> 9999... . . ..._....... Disposal Services: <br /> 15-gallon closed top - Quantityl Container Size Profile #/Waste Type I Spipping Document # Treatment Facility <br /> 15-gallon open topSS� p 10 <br /> % � / Cb... ... F-1-.. (. --- -._._USS ...... . <br /> 10-gallon closed top <br /> .. 9999..... _._ 9999. _ <br /> 10-gallon open top <br /> .. <br /> _ t b5l9 e ZzF�l�yrt� <br /> C <br /> ...- ... __.. . . . .. . . __- .f. J <br /> 5- gallon closed top <br /> 9999_. 9999 <br /> 5- gallon open to .. . . ....3 . TP <br /> 9999.. 9999. _ <br /> 1 - gallon open to <br /> _. I I IF I I I I ...... ... <br /> _9999_.. .............. . . . . . _. _.._ . <br /> PIH Packaging . .. ......... . . .. ..... _9_999. <br /> _. 9999 ....... . .. .. .. <br /> 9999 . . ......... 9999... <br /> 275-gallon tote .......... . .. . ........ 9999. . . . . . . . . 9999..._ <br /> ........_..._ _. .. ....... 9999 <br /> 9.999._.. 9999... ............ . _._..... <br /> Cubic Yard Box ........... - .. . . . . . . . ........ <br /> ._{ ........._ 1 1 1 1 9119... .... .I I I .......... . . � 99__99 � - _ <br /> . . , ._. ...._..... . . . 9999__.. 99.99.._ . <br /> 4ft Light Tube Drum <br /> Bit Light Tube Drum _... e.......... ...._....... .... 9999... 9 <br /> ;999... <br /> Packing Materials # Transportation Services : <br /> Vermiculite. Bag Number of containers Facility/Destination <br /> - .............................. __._____...... <br /> Clay Absorbent, Bag <br /> MMMM . ._....... .. . . . .. ......._. 41FF. .. . . . . . ... ............ }...... ... . .. . .......... . .. . . . . <br /> Bubble Wrap, Roll _- - - - - - <br /> . . . . -.._. ... . . .. ........... _.. . ._ . . ....... .. 9999 .. . ........... . . 9999.._. ............... ...... ... - _...... . . . . . . ............ <br /> Bubble Wrap Bags, Box <br /> Drum Liners .. . .. ...... ... _.........._._. 9999 ..... . .. ......... 9999 <br /> ._............ 999 9 ........... 9999 . . .. ..._..... . . _9_999 . . 9.999... . . .. ..-....... ..... . .. . . .... _ 9999. .. ................ <br /> Pallet <br /> SuperSack Notes: <br /> 9999.. <br /> Radioactive Waste Boxes <br /> Biological Waste Boxes <br /> ........... __,9999 <br /> Red Biological Waste Bags L Labor: Hours/Regular Hours/Overtime Service Provided <br /> Personal Protective Equipment # Project Manger <br /> _ ... . ...... 9999.. .............. .9..9..9..9. . ....1.11.1..... 9999.. ._ <br /> Level D Chemist <br /> . ___. p._... .....- .. 9999.._. ................. .......... .................. <br /> 9999._ . <br /> Level C Technician <br /> 9999. . _4 1- ........ .................. .............. ........... <br /> LevelB _D ........ _. 9 1 1 .............. . . . ... ........... . . . . . _......... <br /> other: <br /> Other Materials # Notes: <br /> 9 .......9,.,119119..... .. ....... ..... .... <br /> ................ . _..._. Customer Signature:. - �'� Date: Q � -' /fes/ <br /> ... ... .. . ... PRINT NAME : <br />