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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. Generetor ID Numher 2. Page i of 3. Emergency Response Phone 4. Manifest Tracking Number WASTE MANIPA4-334-241518 015895804 JJ 5. Generator's Name and MailingAddress Generators Site Address (if different than mailing address) ARAMARK UNIFORM AND CAREER APPAREL LLC 7070 LONGE ST zTOC47011, CA 96200 Generators Phone:209�234-0165 8. Transporter i Company Name U.S. EPA ID Number PHILIP VVES T INDILISTRIAL SERVICES CAP000177527 7. Transporter 2 Company Name U.S. EPA ID Number 8. Designated Facility Name and Site Address U.S. EPA ID Number '.. CHEMICAL t+�ASTE MAiVRCsE1FrSEf'S( INC U.S. 35251 OLD AVL INE ROAD t EiTLEMANI, CA 19323,E Facilitys Phone: aC10-t2'�2-27�73�. 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 wt./vol. NON RCRA, HAZARDOLI ' WASTE, SOLID 1 CM � V _ _�431 Vol z. 3. 4. 9f� � 14. Special Handling Instructions and Additional Information PROFILE A# CA008852 scr22i � � o ® OT 15. GENERATOR'SlOFFEROR'S CERTIFICATION: Thereby declare that the contents of this consignment are fully and accurately escdbed shove 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. if export shipment and I am the Primary Exporter, I cerlity that the contents of this consignment conform to the terms of the attached EPAAcknowledgmam 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 Prue. Ge ratorslOffemrs PdntedlTyped Name Signa re Month Day Year V1 'i1 ® rte �� .. --r 18. Iaternallonal Shipments p- ❑ Import to U.S. ❑ Export from U.S. Pod ofenirylexit: z Transporter signature (for exports only): Date leaving U.S,: w 17. TranspoierAcknowledgmert of Receipt of Materials Transp der l Priatedfryped Nae Sig re Month Day Year O d aTransporter 27idnted yped Name Slgnatu onth Day WE 18. Discrepancy 18a. Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number: 18b. Alternate Facility (or Generator) . U.S. EPA ID Number J U ua- Facility's Phone: Qw 18c. Signature of Alternate Facility (or Generator) Month Day Year Z 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) our t S�t 2. 3. 4, 20. Designated Facility Owner-or Operator: Certification of receipt of hazardous teriala Covered by the manifest except as noted in Item 18a Prided/Typed NameSignature Monl Day Yea EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. DESIGNATED rAOIL1TV TO DESTINATION STATE (IF RE01A RED) i