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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. Page 1 of 3. Emergency Response Phone 4, Manifest Tracking Number WASTE MANIFEST CAL7000405595 314-3112 2408 015895810 JJ K 5, Generator's Name and Mailing Address Generators Site Address (if different than mailing address) .4RAMARIK UNIFORM AND CAREER APPAREL LLC 7879 LONGE ST STOCKTON, Cry 95200 Generators Phone:209+ 2-24-0105 6. Tumspoder 1 Company Name U.S, EPA ID Number PINI LiPVVESTINIDUS RISELSERVICES. e- CAR000177527 7. Transporter 2 Company Name U.S, EPA ID Number 8. Designated Facility Name and Site Address U.S. EPA ID Number CHEM{ CAl 'JtfASTE (t+AAIAGEMENT INC C:$T�U9€i4[�91 ? 95251 OLD SKYLINE ROA KET fL EMANtR, CA 93239 Facility's Phone: 000-222-290A ga. 96. 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. o NON RCR� Fi4RC1OIJS WASTE, SOLID 1 CIO z z. r 3." r 9 3 14. Special Handling Inskuc6ons anclAddiffmal Information i PROFILE 0 CAGOO852 i � �' g 15. GENERATOR'S10FFEROR'SCERTIFICATI6N: I hereby derilare that the contents of this consimmentam fully and accurately descnbed above bythe 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, I(export shipment and I am the Primary Exporter, I codify 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) (if I am a large quantity generator) or (b) (ifi am a small quantity generator) Is two. Ge rotors/ emrs Printe /Typed area Signature Month Day Year / �� ' 114 16, Intemational Shipments zr Import to U.S. ❑ Export from U.S. Pad of entrylexil: Transporter signature (for exports only): Date leaving U.S.: w17. TrensporterAcknowiedgment of Receipt of Materials Tm po er 1 d!T ped Name S' ature Month Day Year Trenspo r2 Printedlfyp dName Signa Month Day Year h T18. 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 U LL Facilityrs Phone: j w 18c. Signature ofAlternale Facility (or Generator) - Month Day Year 3 a I y19, Hazardous Waste Report Management Method Codes (Le., codes for hazardous waste treatment, disposal, and recycling systems) 3. 4. 20. DesignatedFacility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a PriniedfFyped Name Signature Month ryDay iYear Q + � Em C (. EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. DEMON' IATED rACt IL11TS TO DESTNNATI®N3W STATE (IF REQU1RE®)