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Please print or type. (Form designed for use on elite (12-pitch) typewriter) Form Approved, OMD No. 2050-0039 UNIFORM HAZARDOUS 1. GeneratoriD Number 2. Pagetof 3. Emergency Response Phone 4. Manifest Tracking Number g� WASTE MANIFEST C L 0 0 0. Ct 0 5 ° 5 '€ ( 800) 424- 0€300 011178625 JJK 5. Generators Name and Mailing Address Generator's Site Address (it different than mailing address) . ARAMARK 707U, S, LONGE ST, STOCKTCf€'<l CA. 5962016 Generators Phone: ( 20M234- 11105 6. Trans a 1Core any me U.S. EPA ID Number L e 00 11S2 7. Transporter tompany Name - U.S. EPA ID Number 8. Designated Facility Name and Site Address U.S. EPA IO Number t.;HEIV?W.-AL %HASTE €v9Prt` AGEMENT, INC. 3625.1 OLD SKYLINE ROAD C A T 0 0 0 9* 4 0 1 1 7 €iETTLEMAPd CITY CA 932:39 Faciliys Phone: ( 559) 380.. 9711 go. 9b, U.S. DOT Description (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 Wtivo1. NON RCRA HAZARDOUS WASTE SOLID. � GM08862 I 3. g 4. .___ 14. Special Handling Instructions and Additional Information 1 , CA602952 CHE€ 1TRECCONTRACT1`.10CCN 4117 15. GENERATOR'S/OFFEROR'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 am in all respects In proper condition for transport according to applicable international and national governmental regulations. If exportshlpment and I 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 minimizailon statement identified In 40 CFR 262.27(a) (If I am a large quantity generator) or (b) (ff I am a small quantity generator) Is We. G tors/Offeroes Printe9dff�yped Name Signaler Month Day Year V et � f r�9 � /� —r 16, International Shipments ❑ Imped to U.S, ❑ Export from US. Port of entry/exit: Transportersignature (for exports only): Date leaving U.S.: W 17. TranspaderAcknowledgment of Receipt of Materials - Trans der 1 Printed ypsid Name Signa Month Day Year 0 (�v. QTranspdrfier 2 Pdnteillyped Name SIgnaboff Month Day - Year c-- 18. Discrepancy 183. Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Padiai Rejecllon ❑ Full Rejection Manifest Reference Number: 181b. Alternate Facility (or Generator) U.S. EPA ID Number J V Faciliys Phone: w 18c. Signature ofAiternale Facility (or Generator) Month Day Year B 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) ® 1 2. 3, 4, 20. Designated Facility Owner or0peralar. Codification of receipt of hazardous materials covered by the manifest except as noted In Item 183 Printed/typed Name Signature Month Day Year � kk� e T iIq bZ 1 -b lV EPA Farm 8700-22 (Rev. 3-05) Previous millions are obsolete, DESMNATED FACILITY DESTIMATOON STATE (IF REQUIRED)