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Work Order ATTACHMENT A <br /> �•art•� 1210 Ekko Drive 2010 Mission Road 265 Riggs Avenue 13122{mmenila Road 6137 Edilh W RE 511 Highway 213 Work Order# <br /> -:0 S Sunnyvale,CA 94089 Escondido,CA 92029 Merced,CA 95341 Same Fe Springs,CA 90670 Albuquerque,NM 87107 Chaparral,NM 88081 Proposal# 118885 <br /> ACT' 408 548.5050 P 760 489.5600 P 209 722-4228 P 714 545.2191 P 505 349.5250 P 575 624-0164 P Date 24_FEj}17 <br /> enofro 408 548.5052 f 161489-5675 F 209 722.8228 f 714 545.2287 F 505 340986 F 515 824-0208 F acct.sales Manager Pa Flores <br /> Customer Information Service Request ag• <br /> Name: YeryMd LNfled Sdual Dir#. ainteca F t <br /> 40 E Ycts_rttlte Ave <br /> Address: Descriptipn:..__,____._._.__.,_._.__.�.____—__ —_...... <br /> _ ...»....------...___.._...........-----.».».-......_�. <br /> Mi►1[Ccs, CA - . .. _......... __._._ ._... —----_..._._....----- <br /> EPA ID# CALf — ------- _ ------"— <br /> Main Contact: FCtmberfy VMgM20%4&5&OM 4 EDF-BiO_WASTE-PATH-HEALT EWtSE.-_ACT20736 <br /> Phone: 4-EA-38 GWIlon-Skftnrdous gums - <br /> Secondary Contact: 4W-EA-Fuel A En covert' <br /> Phone: erpy Re Free-09r. <br /> PO <br /> Materials and Equipment <br /> Supplies New Reconditioned <br /> Metal Poly Fiber Metal Poly Fiber <br /> 85-gallon overpack —____—._. __._-•__-- __ _. _ <br /> gallonP __ _ _._.._._._..._.._..._.-.___-.__.. <br /> 55 anon open tela o t-._................._..__..._...._._....._._.. ._..._.__._ _�..__. <br /> -9 P P i _ »._.._._..._.__._.._.-. .. ._.__......_..._. �.____-- <br /> 30-gallon closed top <br /> I <br /> 30-gallon open top ; - '-- <br /> 20-gallon ralosed top <br /> �0-gallon open top -- <br /> Services <br /> —+----- --.,.—T—.,._ Disposal Services: <br /> 15-gallon closed top 1 <br /> I Quantity Container Size Profile#/Waste Type Shipping Document# Treatment Facility <br /> 15-gallon open top <br /> ' I <br /> F-- _ <br /> anon closed top i r I I , jfT----y--- �y1+ -__._ ...__............_._. <br /> __. <br /> --gallon open top ; _ .........._»....»__.. <br /> , <br /> 5-gallon closed top <br /> 5-gallon open top '.— _ ; - - --------­--- <br /> 1-gallon open top 1 - - - ` __I*`- - i ••„ --- <br /> --- <br /> PIH Packaging <br /> v ; <br /> 275-gallon tote --.t..._.«..._._... <br /> - _ <br /> Cubic Yard Box ; � I —..._._.._._.__,..„...»_...___-.- -•--_---.«.__._..__.__._ - <br /> ._....... _.{........._.... __.: T <br /> Oft Light Tube Drum _. ........... <br /> .............. <br /> ........_............... <br /> ._.___._._.t__.._.._._ ._.__.I <br /> lift Light Tube Drum i --_ _. .__._._.__ ._._. _....._._._ _......._..........----._._..............._._._._............,.......... <br /> _._._.___....._............ <br /> -__----.-._. —. <br /> Packing Materials # Transportation Services: <br /> Vermiculite, Bag -- - _ -- erofContodners NumbFacility/Destination <br /> Clay Absorbent, Bag _ I <br /> Bubble Wrap, Roll -............ <br /> Bubble Wrap Bags, Box F -•-�--��----� <br /> -_.___.--•-- . _.__.__ .---._._.................. _----____._-_ ----._.._......_._._.... - <br /> Drum Liners ............._._---•--•---.--.__«.»....._.___...._ <br /> r <br /> Pallet <br /> •-•-._._........._.__.... <br /> SuperSack Notes; <br /> Radioactive Waste Boxes <br /> Biological Waste Boxes ---"--�- w' <br /> Red Biological Waste Bags - _..__.__ _ Labor: Hours/Regular Hours/Overtime Service Provided <br /> PerSonal Protective Equipment Project Manger <br /> Level D Cheanist -�- I , <br /> Level C <br /> . .. ... <br /> i <br /> I"pvel B Driver E ; <br /> ._._._._._......._._._..._. ....._._._.«.........._.................__.__........_.._..........«....«.....--•--•--------1 <br /> Other: �......._---._.........._._._......._..._._..» <br /> Other Materials tyt <br /> Notes: <br /> _ <br /> ... Customer Signature: iLr ,- {`y Date- <br /> PRINT NAME: <br />