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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, Pagel of 3. Emergency Response Phone 4. Manifest Tracking Number pp qq WASTE MANIFEST CAL0tJ0a•0559'S `� ' 23:��-27a6u 015895 .820 NJtJK '.... 5. Generators Name and MallingAddress Generators Site Address (if different than mailing address) ARAMARK UNIFORM AND CAREER APPAREL LLC 7679 LONGE ST STOCKTON, CA 96200 Generator's Phone:2119-234'0105 P 6. Transporter 1 Company Name - U.S. EPA ID Number ',.. PHI LIPVVESTiltDUSTPVJkL SERVICES CAR0E0177527 7. Transporter Company Name U.S. EPA ID Number 8. Designated Facility Name and Site Address - U,S, EPA ID Number CHEMICAL WASTE f0AK.AQEMENT INC CAT000040117 3,5261 OLD SKYLINE RGAD KETTLEMAN, CA 93239 Facility's Phone: 800-222-2964 "'.. go. 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 W(Bol. 1. NON RCRA HAZARDOUS WASTE, SOLID CM I '1' � 491 _ 0 66 pf 4. 14. Special Handling Instructions andAddifional Information P¢ PROFILE # CA003852 ® a �I 3170 0 01 15, GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged, marked and labekedipiacarded, 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 codify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. - fI cedify that the waste minimization statement identified In 40 CFR 262.27(a) (if l am a large quantity generator) or (b) (if I am a small quard"oneralod Is free. Generat;Ikoffe rs Prin y edN , Signature Month Day Year temabonal Shipments Import to U.S. ❑ Export from U.S. Part ofentrylexil: sporter signature (for exports only): Date leaving U.S.:ranspoderAcknowledgment of Receipt of Materials derl Dint y ad No a 5' nature Month G /Year Tmnsp erg rioted yped Na a Signatl Month Day )1ar 18. Discrepancy 18a. Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number: 181h. Alternate Facility (or Generator) U.S. EPA ID Number =r U Facllltys Phone: w 18c. Signature afAltemate Facility (or Generator) Month Day Year Q Z 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) Q 1. 2. 3. 4. 20. Designated Facility Owner or Operator. Codification of receipt of zardous materials covered by the manifest except as noted In Item tea Pnmedlfyped Name Signature Month Day Year EPA Form 8700-22 (Rev. 3-05) Previousliditionsareobsolete. DESIGNATED FAD06ITifTO DESTINATION STATE (IF REQUIRED)