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Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved. OMB No. 2050-0039 A UNIFORM HAZARDOUS 1, Generator ID Number 2. Paget of 3. Emergency Response Phone 4. M nifest Tracking Number WASTE MANIFEST C A L sl 0 0 u 0 4 5 9 5 1 SCIt� Ag 2d— '93Ci0t � � � 180910 JJ @�� 5. Generators Name and Mailing Address Generators SiteAddfesS tit different than malting address) ARAMARK 7079 S, LONGE ST. SCOCKTON CA 95206 Generators Phone: 6. Trans orter1 /Company Nama / r U.S. EPA ID Number rl C Yl4 / s..e tr000v lice T 7. Transporter 91impany Name, U.S, EPA ID Number 8. Designated Facility Name and SlteAddress U.S. EPA ID Number CNEMICA0JUASTE MANAGEMENT, INC . 35251 OLD SKYLINE ROAD CAT 0 9 9 0 4 6 9 `'s 7 KED LEMAN CITY CA 93239 1 . Facility's Phone: f' r`s`n9 3$E`' 9711 ga. gb. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers it. Total 12. Unit 13. Waste Codes HM and Packing Group (if any)) . No. Type Quantity WtNol. ® 1' NON RCRAHA ARDOUS '�nAA �E SvL76 GM 2�( (� r V/ / � C:�95852 3. ( M g a 4. 14. Spedal Handling Instructions and Additional Information 3067/ 7 �yG c�A6656 1 . CA.@08852 CHEIVITREC CONTRACTOC=N24117 C ((�� 15. GENERATOR'81OFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged, marked and labeled/placarded, and are In all respects In proper condition for transport according to applicable international and national governmental regulations, peeped shipment and l am the Primary Exporter, Icerft that the contents of this consignment conform to the terms of the attached EPAAcknowledgmenlof Consent. I certify that the waste minimization statement idenlifted In 40 CPR 26227(a) (If l am a large quantity generator or (b) (if I am a/small qua�ntityJgenerator) is true. .V� / N L F `a� � GeneratorsfOffero 's Pdntedffyped Name Sig MPU Year —r 16. International Shipments ❑ Import to U.S. ❑ Export from U.S. Port of en(rylexiC ;a: Transporter signature (for exports only): Date leaving U.S.: 17. Transponer Acknowledgment of Receipt of Materials u• � r,�g Month /DKTa Signature O ay Year Year 16 4 Transporter Vinsheirfyined NameSignature Month Day Year h 000000000 IB. Discrepancy Igo, Discrepancy Indication Sparc ❑- Quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number: 1Bb.Alternate Facility (or Generator) U.S, EPA ID Number J U Z� Facility's Phone: w Ise. Signature of Alternate Fectily (or Generator) Month Day Yaar 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) 20. Designated Facility Ovmeror Operator: Cofficalion of receipt of hazardous materials covered by the manifest except as nded In Item 18a Printedflyped Name Signature Mon ay Year 3 . I EPA Form 8700-22 (Rev. 3-05) Previ seditionsareobsolete. DESIGNATED FACIUP&O DESTINATION STATE (IE REQUIRED: