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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. Generator ID Number 2. Pa e 1 of 3. Emergency Response Phone 4. Manifest Tracking Number WASTE MANIFEST CAL1300405695 d -33 -d4f38 015895800 JJ S. Generator's Name and Mailing Address Generators Site Address (if different than mailing address) ARAA4ARK UNIFOPM AND C,AREEP >APPAREL LLC 7679 LONGE ST STOCKTON, CA 95296 Generames Phone2l[19,434-0106 6. Transporter i Company Name U.S. EPA ID Number PHILIP WEST INDUSTPIAL SERVICES C:�aR0C3C1177547 7. Transporter Company Name U.S. EPA ID Number 8. Designated Facility Name and Site Address U.S. EPA ID Number CHEMICAL WASTE MANAGEMENT INC CATODOL140117 35451 OLD ,SKYLINE ROAD KEITLEMAN, CA 93439 Fm illy s; Phone: 1300-222-4964 go. 9b. US. 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 Wt.//oh 1. o NON RCRAHAZARDOUS 'LIASTEtSOLI D 1 CM � Y 491 gal 9 3, 4. 14. Special Handling Instructions and Additional Information PROFILE * CAI!l08652 D Alt 2 oo 15. GENERATOR'SIOFFERORB CERTIFICATION: I hereby declare that the contens of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged, marked and labeledlplacarded, and are in all respects in proper condition for transport according to applicable International and national governmental regulations. If export shipment 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 minimization statement identified in 40 CFR 262,27(a) (it l am a large quantity generator) or (b) (it I am a small quqtintly generator) is true. Generator Offe sPrinte Nam Signator , Month Day Year Ile 116 J 16. International Shipments '. i-- ❑ Ira rtlo U.S, Export from U.S. Port ofenirylexit: Transporter signature (for exports only): Date leaving U.S.: w 17. TransporterAdmowledgment of Receipt of Materials Transod6f ri dfTyped N e Signator Month Day Yea a U E 1 aTransporter 2 PantefflTyped Name Signature Month Day Year r - 18. Discrepancy 18a. Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number: 18b.Atiemate Facillty (or Generator) U.S. EPA ID Number J U LL Facility's Phone: �. w 18c. Signature of Alternate Facility (or Generator) Month - Day Year Q z 19. Hazardous Waste Report Management Method Codes (i.e., erodes for hazardous waste treatment, disposal, and recycling systems) ® 1. 2. \, 20. Designated Facility Owner or Operator: Codification of receipt of hazardous materials covered by the manifest except as need in Item Ise Pnntedffyped Name Signature Month Day Year EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. DES90WIATED FACILITY TO DESTINATION STATE (IF REQUIRED) 1