TE 1 Task Order Form.docx

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Hazardous Waste Testing
Solicitation number
W912CN-20-Q-0010
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CONTRACT NUMBER

TASK ORDER NUMBER:

General Information

Task Order Date:

Item Number(s):

Quantity/Unit:

Facility and Building Number:
6040 East Range
Facility Contact:
Name: Barry Feleciano
Telephone: 864-1085/656-0866
Task Order Primary Contact:
Name: Preston ButhComment by Tetla, Robert A CIV US USA IMCOM: Former Peter Anzalone
Telephone: 864-1381/656-0866Comment by Tetla, Robert A CIV US USA IMCOM: Former 479-4991
Task Order Secondary Contact:
Name: Robert TetlaComment by Tetla, Robert A CIV US USA IMCOM: Former Gary Akasaki
Telephone: 498-1040/656-3097Comment by Tetla, Robert A CIV US USA IMCOM: Former 864-1001/656-7001

DESCRIPTION OF WASTE STEAM(S),CONTAINER(S), AND TASK(S)

Container Description
Waste Description
Field Sampling Notes
No.
Size
Type
Sample No.
%

full

% liquid
% sludge
%

solid

Order Accepted As Shown:

Waste Management Date:

Microsoft_Excel_97-2003_Worksheet1.xls Sheet1

Item No.Qty.UnitUnit $$ Amount
This OrderPrevious AllotmentCumulative
Total $ Used (Includes Current Order)Original

Total Allotment Unallotted Balance Remaining This DO

$ - 0 $ 415.66 $ 415.66 $ 445.35 $ 29.69

$ - 0 $ - 0 $ - 0 $ 171.87 $ 171.87

$ - 0 $ 423.00 $ 423.00 $ 705.00 $ 282.00

$ - 0

$ - 0 $ 59.38 $ 59.38 $ 118.76 $ 59.38

$ - 0 $ - 0 $ - 0 $ 171.87 $ 171.87

$ - 0 $ 1,433.32 $ 1,433.32 $ 2,149.98 $ 716.66

$ - 0 $ 1,086.48 $ 1,086.48 $ 2,172.96 $ 1,086.48

$ - 0 $ 70.61 $ 70.61 $ 5,000.00 $ 4,929.39

$ - 0 $ - 0 $ - 0 $ 288.54 $ 288.54

$ - 0 $ - 0 $ - 0 $ 226.75 $ 226.75

$ - 0 $ - 0 $ - 0 $ 898.00 $ 898.00

$ - 0 $ - 0 $ - 0 $ 4,140.00 $ 4,140.00

$ - 0 $ - 0 $ - 0 $ 774.00 $ 774.00

$ - 0 $ 992.00 $ 992.00 $ 1,984.00 $ 992.00

$ - 0 $ 9,504.00 $ 9,504.00 $ 19,800.00 $ 10,296.00

$ - 0 $ - 0 $ - 0 $ 875.00 $ 875.00

$ - 0 $ - 0 $ - 0 $ 898.00 $ 898.00

$ - 0 $ - 0 $ - 0 $ 4,140.00 $ 4,140.00

$ - 0 $ - 0 $ - 0 $ 774.00 $ 774.00

$ - 0 $ 992.00 $ 992.00 $ 1,984.00 $ 992.00

$ - 0 $ 9,504.00 $ 9,504.00 $ 19,800.00 $ 10,296.00

$ - 0 $ - 0 $ - 0 $ 875.00 $ 875.00

$ - 0 $ - 0 $ - 0 $ 875.00 $ 875.00

$ - 0 $ - 0 $ - 0 $ 875.00 $ 875.00

TOTALS $ - 0 $ 13,984.45 $ 13,984.45 $ 39,922.08 $ 25,937.63

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