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Z FERCUS0N' <br /> Nobody expects more from us than we do <br /> .�. Fer�uSoit,bpnxsHanrdairtlllasoe-PfcktWRegt�est FJectronicOrdet�IFcrtrf' - - - <br /> Form Instructions: -- " <br /> Fill in the Gray Colored Boxes. Provide as much detail as possible. Email the completed form to: Fergusonretail@deanharbors.com Don't forget to include the SDS and photos of the waste if avalable) <br /> Questions on this form: Contact Drew Hartsock at drew.hartsock@ferguson.com or 757-969-4725 <br /> Ferguson Location Number 321 Ferguson Contact Person Lnralie Maraslnag - <br /> Ferguson LOCATION STATE California - Ferguson Contact Telephone (209)943-8387 <br /> DATE OF REQUEST IFerguson Contact Email Lora lie.Macasinag0ferguson.com <br /> . <br /> CONTAINERTYPE Accumulation Start Date{Date <br /> Ferguson WASTE DESCRRJTION PROFILE NUMBER (How many pieces of the waste[tern) (What kind of drum is the waste in;poly,steel,etc) Unit of Meawrement(Size of container) Ident1fled) <br /> UPS Battery Pack(Power Sonic) _ '15 Mastic Case and Cover each <br /> Absorbent w/Hydra ulkOil 3Mastrc.Bag 12-16 Gallon 3 MIL(Not Full) 7/9/2018 <br /> Absorbent w/Battery Add 1 - Plastic Bag, 12-16 Gallon 3 MIL(Not Fult) -.9/10/2018 - <br /> Disinfectant Cleaner 1` Plastic Bag in a box 25 Liter 8/17/2018 <br /> Paint Thinner(Empty) i Can 1 Quart 9/13/2018 <br /> Ceiling Texture 2 Aerosol Can 14 cz 9/13/2018 <br /> Power Leaner Degreaser 1 Plastic Bottle 1 Quart 9/14/2018 <br /> Multi-Purpose Ceramic Tile Cement 3 Plastic Bucket i Gallon 9/25/2018 <br /> Odor Eliminator. <br /> 2 - Plastic Bag Z Liter 9/26/2018 <br /> (Battery)Acid Wash Water Z. - Poly Plastic Drum 55 Gallon 9/26/2018 <br /> Absorbent w/(Battery)Acid Wash _ <br /> Water,PPE used to transfer the water <br /> waste. 1 Poly Plastic Drum- 20 Gallon 9/26/2018 <br /> Floor Stripper- 1 Plastic Bag in a box 5 Gallon .10/1/2018 <br /> Clean Harbors Container Code Container Type Cost per Item Number of Containers/Items Needed Special Notes <br /> OM55STL 55 Gallon Drum Reconditioned-DOT Rated $ 55.00 - - - Hawaii Locations contact Drew Hartsock for pricing <br /> DM55POLY 55 Gallon Poly Drum-DOT Rated $ 75.00 Hawaii Locations contact Drew Hartsock for pricing <br /> DM20POLY 20 Gallon Poly Drum-DOT Rated $ 45.00 - Hawaii Locations contact Drew Hartsock for pricing <br /> DM5POLY 5 Gallon Poly Pail-DOT Rated $ 16.00 - Hawaii Locations contact Drew Hartsock for pricing <br /> VERMSORB I Vermiculite Absorbent $ 19.00 Hawaii Locations contact Drew Hartsock for pricing <br /> BOXB 18 Foot Light Bulb Box $ 20.00 Hawaii Locations contact Drew Hartsock for pricing <br /> BOX4 14 Foot Light Bulb Box $ 15.00 - Hawaii Locations contact Drew Hartsock for pricing <br />