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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 Trucking Number pp pp �J WASTE MANIFEST cA oaoa.rr55p.6 R/24-334.-240x4 015895828 d2A � 5. Generators Name and Mailing Address Generators SlteAddress (if different than mailing address) ARAMARK UNI NOW AND CAREER APPAREL LL`: 7079 LONGE ST STOC:KT ON, CA 95200 Generalor's Pham,2094'2 14_g]! 05 6. Transpoderl Company Name U.S, EPA ID Number �„•gl PH]11P PWEST € NOUST F �,L SEPt7fGE �� 7. Transporter 2 Company Name U.S. EPA ID Number 8. Designated Facility Name and Site Address INC, . EPA ID Number &-IEI�>liCt�L WASTE MANAGEMENT" 61"0 CAT icOMle'187. 35251 OLD SKYLINE ROAD KE-lTLENIAN, CA 93299 Facility's Phone: 1992-222.29514 ga, 9b. U.S. DOT Description (including Prefer Shipping Name, Hazard Class, ID Number, . 10, Containers II. Total 12. Unit 13. Waste Codes HM and Packing Group (if any)) No. Type Quantity Wt.Nol, Y o NON RCRAHAIARDOUSb`1E.ASTE, SOLID 3 Chi Y �J11:1H_—_ f y W 2. 0 R ( 3. i I f 4. f 14. Speclal Handling Instructions and Additional Information FPOF1 LE ft CA,008852 15, GENERATOR'SIOFFEROWS 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 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 conform to the terms of the attached EPAAcknawledgment 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) (if l am a small quantity generator) is true. Generatoes/Offerord antedlf ma Signature Month Day Year —1 16. international Shipments '. F-- 11 import to U.S, ❑ Export from U.S. PonofentryfaxiC Transporter signature (for exports only): Date leaving U.S,: '. w 17. TransporterAcknowledgment of Receipt of Materials '.. Tm der i Pdnied7fyped N Signature Month Day Year aDeLAU QTransporter 2 Printe i fyped Name Signature Month Day Year K h 18. Discrepancy Inc. Discrepancy Indication Space ❑ Quantity ❑ Type -❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number: 1 8b.Alternate Facility (or Generator) U.S. EPA ID Number '.. J U LL Facllltyzs Phone: - w life. Signature ofAltemate Facility (or Generator) Month Day Year B 19. Hazardous Waste Report Management Method Codes (I.e., codes for hazardous waste treatment, disposal,"and recycling systems) Q t 2. 3. 4. `�z '.. 20. Designated Facility Owner or Operator: Cedigratton of receipt of hazardous materials covered by the manifest except as noted in item Ise Pdntedffyped Name , . Signature Month Day Year Q YJ3 EPA Form 8700-22 (Rev, 3-05) Previous editions are obsolete. DEM0NATED FACILOTV TOO DESTONATOON STATE OF RE QUHRED)