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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 Mr 3. Emergency Response Phone 4. Manif at cking Number WASTE MANIFEST CAL 000405505 °>44-334-22.0'3 0 895806 JJ K 5. Generator's Name and Mailing Address enerators Site Address (if different than marling address) - APAMARK UNIFORMAND CAREER APPAREL LLQ 7070 LONGE ST STOC€;TON, CA, 05200 Generators Phone:209434'0105 6. Transporter 1 Company Name U.S. EPA ID Number PHILIP V'VEST INRI.ISTRIAL SERVI :'ES CARG00177527 7, Transporter 2 Company Name U.S. EPA ID Number 8. Designated Facility Name and Site Address U.S. EPA ID Number CHEMICAL WASTE MAdtIAOEItf,EI1tT INC CAT0000409 17 35251 OLD SKYLINE ROAD KET LEMIAN, CA 03130 Facililys Phone: 8000 2224004 ga 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.Nol. L tt s o NON RCRA. HAZARDOUS WASTE, SOLID 1 CMp V ;4:�I" jo _ 1'�. _ !! f z 2. W s 3. I 4 4. ` 14. Special Handling Instructions and Additional Information PROFILE N CA608852 PSCAt 112 2�s I C51WDQ10 • JfW0 INt ZoPq 15. GENERATOR'SIOFFEROWSCERTIFICATION: I hereby declare that the contents of this ffinsignment arefuly andaccurately described above by the propershipping name, and are classified, packaged, marked and labeled/placarded, and are In all respects in proper condkion 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 4o the terms of the allached 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 true. G lots70ffemrs Pnnttedl/fypfd Name Signet Month Day Year —r 16, Intemattonal Shipments ❑ Import to U.S. ❑ Export from U.S. Pod of entrylexd: z Transporter signature (for exports only): Date leaving U.S.: W 17. TmnspoderAcknoMedgmentof RemiptofMatedais Terraria er 1 Printedrryped Name SIg re Month Day Year ® /1a ZTransports 2Pdnted yped Nama SignatVir Month Day Year t�- 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 V LL Facility's Phone: w 18c. Signature of Alternate Facility (or Generator). - Month Day Year a z 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 or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a PrIntedgryined Name _ Signature Month Day Year RIP EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILPTY TO DESTINATION STATE (IF REQUIRED)