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Ale' . Please print or type. (Form designed for use on elite (12-pitch) typewrites) Form Approved. OMB No. 2050-0039 '.. UNIFORM HAZARDOUS 1. Generator ID Number 2. P e 1 of 3. Emergency Response Phone 4. Manifest Tracking Number g g� WASTE MANIFEST CAL000405595 644-334-2408 015895895 JJ K S. Generators Name and Mailing Address Generators Site Address (9 different than mailing address) ARAMARK UNIFORM AND CAREER APPAREL LLC 7079 LONGE ST STOCKTON, CA 35206 Generators Phone:269434-3105 '... 6. Transporter l Company Name U.S. EPA 10 Number '.. PHILIP WEST INDUSTRIAL SERVICES wAR000177627 7. Transporter 2 Company Name U.S. EPA ID Number 8. Designated Facility Name and Site Address U.S. EPA ID Number ',. r_:i-iEMIUl�tL 'z?VA,STE MANAGEMENTINC Cir000646117 35551 OLD SKVLINE ROAD KETI-LENI AN, CA 93233 Facility's Phone: 3£it.t-222-2904 go. 9b. U.S, DOT Description (including ProperShipping Name, Hazard Class, ID Number, 10. Containers 11, Total 12. Unit 13. Waste Codes '. HM and Packing Group (9 any)) No. Type Quantity Wt./Vol. t P 0 NON RCRA HAZARDOUS WASTE, SOLID 1 Cm � VQrT491 flE Qd w i 1 (a x 4. h 14. Special Handling Instructions and Additional Information PROFILE # CA608852 15, GENERATOR'SIOFFEROWS CERTIFICATION: I hereby declare that the contents of this consignment.are fully and accurately described above by the propershipping name, and are classified, packaged, Marked and labeledlplacarded, and are in all respects in proper condition for transport according to applicable intercultural and national governmental regulations. Ifexpod 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 codify that the waste minimization statement idendfied In 40 CFR 26227(a) (if I am a large quantity generator) or (b) (If I am a small quantity generator) Ia two. G90 rsl0 owes Pted/Typed NameSignat> � Mo Day �r —r 16, International Shipments i-- ❑ Impart to U.S. ❑ Expert from U.S. Pod of entry/exit: g Transporter signature (for exports only): Data leaving U.S: w 17. TransporterAcknowiedgment of Receipt of Materials Tran er P - ed pe me Sign re M Day Yar O fp a UPI Ab Tmnspo erg Pnntedffy dName _ Signaturlir Month Day ar 18.Discrepancy 18a. Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Pull Rejection Manifest Reference Number: 18b. Alternate Facility (or Generator) U.S. EPA ID Number Zi L) iIr< Facility's Phone: w fro. Signature ofAltemate Facility (or Generator) Month Day Year Q z y19. Hazardous Waste Report Management Method Codes (I,e„ codes for hazardous waste treatment, disposal, and recycling systems) ® 1. 2. 4,. 3. 4. '.. rS2, 20. Designated Facility Owner orOperator. Codification of regillpt of hazardous materials covered by the manifest except as noted in Item Ise Printed/fyped Name / Signature Month Day Year EPA Form 8700-22 (Rev, 3-05) Previ s editlons are obsolete. /' rOESMWATE rD FACILITY TO DESTINATION STATE (I F REQUIRED)