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® ® 6212 a 75th Avenue M4 Mer Riggs A95341 Santa Fe Springs,C Road 4De Denver, CO 8 Street WORK ORDER %,6600♦� Home Office' Laveen,AZ 85339 Merced,CA 95341 Santa Fe Springs,CA 90670 Denver,CO 80216 FACT967 Mabur Road% Sall Jose,CA95133 21110 Mission Road 600 Iowa Street 6137 Edith Blvd 71 511 Highway 213 Work Order#t 408 548-5050 P Escondido,CA 92029 Redlands,(A 92373 Albuquerque,NM 87107 Chaparral,NM 88081 Propo#al# 5u5RfiF,/1/L.�f1Ad1 enviro 408548-5052F 24602 Pacific Hwy5 4Wayne Court Building 9 - 208 Murray Road SE 13600 SE Ambler Road Date Kent,WA 98032 Sacramento,CA 95829 Albuquerque,NM 87105 Clackamas,OR 97015 Acct. a� es_lanager Customer Information Name: nal Service Request - Rnh R Address: UniFirst-FREI�I IOUW De np I n:........................................................_......._._.......... Y 819 N. Hunter St ......................_..........................._..........._.........................._........................._...................._......._.._._.........._.._.__......_.._...._..._.__...._ _..._._.._.__..__.. Prepared byThomas-Pit and Tranch Cleaning!Please pull a sample EPA ID# ...................__...-..._,WATEf3;6LIJflFE-24324-888�fF' 7/1.5F2G25-__.____.._._..._.._____..__..____ Main Contact:')Ckton, CA M02 1,-EA-Wash Out Fee Phone: ......................._..................................................................... CAL.000276373 s=�A-Personal Protacd%e Equipment k4sc. SecondaryContact: ...................... ............_._......-_------_.-.-......_........._...._.._------.._.._.. Phone: u Trans 702-326.2943 ...........1 -EA-Stakebed Truck 8 Liftgate(Response Unit) ............._._.._........_...:. _:. ...:__......._........_._..._.. PO# 1 - A-Conilhed Space-Equlprneht ......................... Rrcect Mar►ager.. ..OT............................._..._.............._......... _.._ __......._.. _.. Materials and Equipment -HR-Labor-Technician @ OT Reconditioned ""'............. Supplies New =FTR-•Labor••-ronline�•Space•Tech-Team-of.�.._.............._..____..................._....._..._...._...... Metal Poly Fiber Metal Poly Fiber . ................._-H.Ft..-..Labor... Tank@r...Qriver... ..QT......_..._....._..._._..__..._....__._................_. 85-gallon overpack i _..................... I -EA-Manifest Fee 55-gallon closed top i ; ........._.._--- _._..._...__.............. .......................... __...._.__ _... _i ..._. -.__._....... € .EX1-Eiwvii+OrflBitt SiYiirriy...Charg _ 55-gallon open top ...........-..H.R..m.iLA13.Qftj.'.ANKER..Q.Niuef(M..D.aubt,a._Time..Raie..____...._.._._____..._...._._.........._ _ ..i______.._...._..__._.. ..._............'s...._`._....._........_. 30-gallon closed top .i -HR-Labor-Technician Saturday Rate .._..i_...._..._._............ ._.._..._. .... ................. .......................T..._.E.iec.._.Anat i ats..........................................................___............................. --- — _...�----------- ._..._..._.. 30-gallon open top yt ... ............... 20-gallon closed top _ _..._._...._.._.............. i ......_...........,...._..........._.............. Services 20-gallon open top --_i......_.............__..---------- ... Di . 15-gallon closed top i i i. Disposal Services: _.._._I..._..._.._._. .._........_ Qua tity Container Size Profile#/Waste Type eShipping Document# Treatment Facility 15-gallon open top € € € •? = .. ..._...°�.......... br i ., .............._....... 10-gallon closed top : ............ __...__._:.._...._..... _......... ..._..._.. .__..........__;_......_........;..._ . 10-gallon open top ........................................._...._._ ___.._......_._.._...__. ._..._. _..-•--._ __ _........ ......................_N........................_...................1.......... .......... ------..i._.......... 5-gallon closed top _.......__I_..............._............_......................__..... ....._......_.... .......................i........... 5-gallon open top € i ............. .......... ...................................................... i....%...................�...._...._.._ . _ ___. _.._._.__._._......._........._.... _.. .... .. 1-gallon open top . ........ ......................:..i .................................._.......;.... _......-..............................._....... ......_........ _ __...................... PIH Packaging _ r .............__...:......._....._.:_..._....................__.......... ............ ..... 275-gallon tote - _......_;_..._.....__.;........._..........._.._....._....>._..........._ ................ . .............. ..... ..._......._.._....... _ ..... _...........3...V,.... _ % Cubic Yard Box / , ................. __.......x....._............ ...........`....+...i........:........................................:.... ►.:......._...................._._....._ ........__..._......_...._....................---....... 4ft Light Tube Drum - r _..-I----._..........-_....................................-............................. ..............................................................._...... ............................................ ........_.._..-.......... 8ft Light Tube Drum, Packing Materials # Transportation Services: Vermiculite,Bag Number of Containers;, FacilityTestination v b Clay Absorbent, Bag _. nl erg / gyp/,� ." ....._.. ............... ..................�.......x..........................................;...._.........................................................�_...i./:lt..._�....__...._..._._...._.__....._..._...._..................._.........._.._......_..........._ Bubble Wrap,Roll ........._....._........................................... y............r....r.....t......................................................_........................................_......_......_.._..............._........_......._....._._....................._........._...._._.._...... Bubble Wrap Bags,Box - Drum Liners ........_...............................I.................... ........................................................................................................................................................._._................._............_.............................._......_._.._..... _ ................................................_.............. .......................................................................... . . : ......._..__..............._....._. _� ... .........._.............._....___,.__.__.__ ...... Pallet SuperSack Notes: Radioactive Waste Boxes ................................................................ Biological Waste Boxes Red Biological Waste Bags Labor: Hours/Regular Hours/Overtime Service Provided Personal Protective Equipment # Project Manager I ... ........ .. ...... ._..._..... _........... ..................................................._------,..........._..........................._..............,........ ............................. . Chemist Level D ............................................................._....;...._.._.................... _........_..__...__.......;..........................................._..........._......................._.__._...._.........-........ .......................I.............................. Technician I i LevelC ._....................................................................:........................._......................... i _._...._._...._........ Driver Level B ..................................................._._........................_.............._............_......................................................._............. ............... Other: I Other Materials # Notes: ............._..._........................ Customer Signature: Date: .....................I............._..........._.... . ............................................................... PRINT NAME: `�