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Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved. OMB No. 2050-0039 UNIFORM HAZARDOUS 1. GenemtorlD Number 2. Page 1 of 3. Emergency Response Phone 4. ManifestTracking Number WASTE MANIFEST C A L G L 0 4 6 1 ( 800) 4 > 4- 93517 011178623 JJ K 5. Gememtors Name and Mailing Address Generators Site Address (if different than mailing address) ARAMeARK 767P' S , LONGE ST. ST0CKTON CA 96205 Generators Phone: ( 2llg) 234 - 0 1 LG 6. Transporter I Company Name U,S, EPA ID Number Rh _� ` r.6 P . -.- 7. Tmnspoder2company Name U.S. EPAI Number 8. Designated Facility Name and Site Address U.S, EPAID Number CHEPvlICA L WASTE IVIAN AG EMENT, INC. 36251 0LD SIS; LINE R0An C A T !`_t 0 G 6 4 0 1 1 7 Facililys Phone: ( 669086- 9711 go. 9b. U.S. DOT Desorption (including Proper Shipping Name, Hazard Class, ID Number, 10, Containers 11, Total 12. Unit 13. Waste Codes HM and Packing Group (if any)) No. Type Quantity WUVol. I 1. NOBS RCRA HAZARDOUS WASTE SOLID y { 491 � t=AB0885'= pp ' No 2. R c� 3. I 4. p jgNqj 14. Special Handling instmcfions and Additional Information 1 , CA6178862 CHEBOTREC C-0NTRACT CN24117 iwm) 15. GENERATOR'SIOFFEROR'SCERTIFICATION: Ihereby 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 condlgon for transport according to applicable international and national governmental regulations. If export shipment and l am the Primary Exporter, I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. I certify that the waste minimization statement identified In 40 CFR 262,27(a) (if I am a large quantity generator) or (b) (if I am a small quantity generator) Is two. Ge toesfOBerors Pdnteciffyped NameSigna> Month Day Year 16. International Shipments r [A import to U.S. - ❑ Export from U.S. Portofentryfexit Transporter signature (for exports only): Date treeing U.S.: a= 17, TransporterAcknowledgmeni of Receipt of Motorola _ j2 Transporter 1 Printedfryped Name Signature Month Day Year QTransporter 2 Printed(Typed Name /Signthice "' Month Day Year ad r- 18. Discrepancy 18a. Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Parlal Rejection ❑ Full Rejection Manifest Reference Number: 18b.Alternate Facility (or Generator) U.S. EPA ID Number J U Facilitys Phone: W 18c. Signature of Alternate Facility (or Generator) Month Day Year 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) m 1 2, 3. 4. C3 \`�S 29. Designated Facility Ovref or Operator: Ceriflcation of receipt of hazardous materials covered by the manifest except as rated in Item 18a Printedrfped NameQ � � Signature Month- o, (`(Day Year Am Ar . I (P EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IE REQUIRED)