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Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Farm Approved, OMB No. 2050-0039 UNIFORM HAZARDOUS 1. Generator ID Number 2. P gelof 3. Emergency Response = 015895824 hone 4. Manifest Tracking Number WASTE MANIFEST . CAL900905595 0158958 2 4 J K S. Generator's Name and Mailing Address `; Generators Site Address (if different than mailing address) ARAMdARI e LINIFrSRM AND CAREER APPAREL LLC ' . . 7079 LONGE ST STOCKTON, CA 952Q@ Generator's Phone:2QI 2346 10101 6. Transporter 1 Company Name U.S. EPA ID Number '.. PHILIP WfECT If SDU I`�I I.AL SERVI C ES Jr e . 7. Transporter 2 Company Name U.S. EPAID Number 8. Designated Facility Name and Site Address U.S. EPA ID Number CHEMICAL 'WASTE MANAGEMENT INC CATWG&6117 35251 OLE' SKYLINE ROAD l•CETTLEMAAJ, CA @32M FaclliVs Phone: 800-222_296 ,2 its. 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11. Total 12. Unit 13. Waste Cartes HM and Packing Group (if any)) No. Type Quantity wt./Vol. r CP!1i Y. NDN RCRA HAZARDOUS NDt ,t WASTE, SOLID 913 d r 3. I 4 i 14. Special Handling Instructions and Additional information 1 PROFILE 0C.A@08s52 pp�� 15. GENERATOR'SIOFFEROWS CERTIFICATION: I hereby declare that the contents ofihls consignment are fully and accurately described above by the pruperahipping 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 certify that the contents of this consignment confomr to the terms of the attached EPAAcknowledgment of Consent, I sedgy 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 ime. Generators/Ogeroes P ' tedlTyp Signature Month Day Year '.. /_- G � J 16. Intemationa S ipments ❑ Import 9 U.S. El Export from U.S. Pod of entry/exile Transporter signature (for exports only): Date leaving U.S,: '.. IX 17. TmnsponerAcknowledgment of Receipt of Materials E Transport 1 Priinntruptyped Name Signa Month ,ryDay Year o ORAE m G a Transpoder2 Printed/typed Name Signator Month Day Y r rK F 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 J U I ❑a- Facility's Phone: 18c. Signature ofAfiernme Facility (or Generator) Month . Day Year 19. Hazardous Waste Report Management Method Codes le., codes for hazardous waste treatment, disposal,and recycling systems) 4. 20. Designated Facility Owner or Operator: Codification of receipt of hazardous materials covered by the manifest except as noted in Item Its Printed/typed Name Signature Month Day Year :VI EPA Form 8700-22 Rev. 3-05 Previous editions are obsolete. ( ) rDESUMAgE® raChILITV T® ®ESTCNATI®N STATE gay REQUIRED) i