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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 TrachingNumberr J J pp pp WASTE MANIFEST CAL 844-334 24k�n ® 15895813 K S. Generators Name and Mailing Address - Generators Site Address (if different than mailing address) '.. ARAMARK UNI FORM MID CAREER APPAREL LLC 7679 LCNCE ST STOCKTON, CA 952136. Generators Phone:20 u-234-0 s Orb '.. 6. Transporter 1 Company Name U.S. EPA ID Number PIaIILlP WEST I N DUST PIIbL `_:ER ICES C-AFOOOD 177627 7. Transporter 2 Company Name U.S. EPAID Number 8. Designated Facility Name and Site Address _ U.S. EPA ID Number CHUM F4 CAL Vir'ts=.TE MAXA zEMENT INC CATBt?�1€i 181 '17 35251 CLD SKYLINE�:G,4C} KE TLEMAS 4, A GYM Facilily's Phone: 8000 222=29&4 9a. 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 Quality Wt.A/ol. 1. o NON I CRA F1AZAPDOUS 0WASTE, SOLID i CIVI � f rdgt �I e ¢r z 2. r I I { { 3. ) 7 1 4. s Ii 14. Speclal Handling Instructions andAddltional Information PROFI LE O CA008852 15. GENE 0 '9I rFiER0RSCERvTIFJCATIOkI: J1heislay declare that the contents of this consignmenare fully and accuratelydescdbedabove by the proper shipping name, and are classified, packaged, marked and labeledlplacafded, and are in all respects in proper wndidon for transport according to applicable international and nalional governmental regulations. If export shipment and I am the Primary Exporter, I muggy that the concerns of this consignment conform to the terms of the attached EPAAcl nowledgmenl of Consent. I cedify that the waste minimization statement identified In 40 CFR 26227(a) (if i am a large quantity generator) or (b) (if I am a small quanii tor) Is two. CaneralorslOff ors Pri pe d a(fne Signature Month aDayg Year 16. Intonational Shipments i— ❑ Import to U.S. ❑ Export from U.S, Pod of entry/exit: Transporter signature (for exports only): - Date leaving U.S.: - wV. TranspoderAcknowledgment ofRecelpt of Materials Tm er i d ed Name S' afore Month Day Year U) % QTramicalli- 2NiAtecirrydadName Sign e ' - Month Day ar 18. Discrepancy 18a: Discrepancy Indication Space ❑ Quantity ❑Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection M1 J. Manifest Reference Number: 18b, Alternate Facility (or Generator) - U.S. EPA ID Number - U 4 <a Facililys Phone: w 18c. Signature ofAlternate Facility (or Generator) Month Day Year Q z U5 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) a 0 1. 2.• - 3. 4. 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted tri Item 18a Printedrryped Name Signature Month Day Year o4 I Ll 111 EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. 9ES110MAT ED FA.C6& Orr TO ®ESTOMATION STATE (OF REQUIRED]