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le as print or type. (Form designed for use on elite (12-pitch) typewriter) y - Form Approved. OMB No, 2050-0039 UNIFORM HAZARDOUS 1, Generator ID Number 2. P go 1 of 3. Emergency Response Phone 4. Manifest Tracking Number pp pp pppp WASTE MANIFEST . CALLIOW16595 8/W334-2403 015895818 J J K 5. Generator's Name and Mallfng Address Generators Site Address (if different than mailing address) ,RAMAR6£ UNIFORWI AND CAREER APPAREL LLC 76679 LONGE ST STOCKTON, CA 952061 Generators Phone:20L' '2 —911Th 6, Transporter 1 Company Name U.S. EPA ID Number WILIP VVESs INDUSTRIAL SERVICES CAR000177527 7, Transporter 2 Company Name U.S. EPA ID Number 8. Designated Facility Name and Site Address U.S. EPA ID Number CHEIUICAL VvItASTE MANAGEMEN § I 1 N % � 1 F�QCieF9u17 ' 35251 OLE) SKYLINE ROAD FET T t EC,9t 1% CA 03239. Facility's Phone: 800_222_29`9 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 WtAml. 1 € ' idN,i RCRA F ? sIDOI15 Vi1.AS.TL=, SOLID 1 CN i V 491 —i J qa --1 w2, 4 � d f N 3. 77 ,pG� f3 I 14. Special Handling Instoodons and Additional Information PROFILE 4 CAP508852 Q� Q�7 1 15Q Olga 15. GENERAT WSIOFFEROWS CERTIFICATION: I hereby dealers gal the contents of this consignment are fully and accurately described above 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 cerfily that the contents of this consignment conform to the terms of the attached EPAAcknowledgmenl 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 free. Generators[ -eror d/fypyd Name Signgdbna Month Day Year 4 �. ► 177 --r 16. International Shipments r ❑ Importto U.S. El Export from U.S. Port ofentrylexiC Transporter signature (for exports only): Date leaving U.S.: w17 emsporterAckgowledgment ofRecelptofMaterials - rang 000 at T1 yped No Sig are Momh Day Year CL QTrans rter2 dole yped Name Signatu Month gay Yak 18. Discrepancy j 18a. Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number: 181h. Alternate Facility (or Generator) 0.3. EPA ID Number :3 U I <+ Facililyrs Phone: 18c. Signature ofAlternate Facility (or Generdtor) - Month Day Year 19, Hazardous Waste Report Management Method Codes (I.e., codes for hazardous waste treatment, disposal, and recycling systems) o 1. 2. 3. 4. E J 20. Designated Facility Owner or orator: Cerif cation of recelpt of ha Nous materials covered by the manifest except as noted In Item 189 PrinledfTyped Name SignatureMonl Day Year EPA Form 8700-22 (Rev. 3-05) Previous eclificank are obsolete, B:ESIGHATECS rACILITiY TO ®ESTONATON STRNTE (IF REQUIRE )