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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 Tracking Numberp pp �// WASTE MANIFEST CALE08f3'1. 45595 "t3� -3ii E-2F3 015895831 eJNJ IPV 5. Generators Name and Mailing Address Generators Site Address 01 different than mailing address) ARMAARK UNIFORM AfiD CAREER APPAREL LLC 7679 LONGEST STOCKTON, CA 062W Generatots Phone: lag-234,.,0103 U.S. EPA ID Number 6. Transporter 1 Company Name PHILIP VVEST INDUSTRIAL SERVICES 7. Transporter 2 Company Name O.S. EFA In Number 8. Designated Facility Name and Site Address C .S. EPA ID Number F1E4?�ECa�. WASTE61��,s3E[>�E4'dT INCINCrATuCtitCi-46 117 36251 OLD SKYLINE ROAD {zE TLEMAN , CA 93239 Facillt>1a Phone: 600-222-2964 ga 91h. 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 WtNal. a 0 NON RCRA I ARDOLIS WASTE, SOLID � CM � Y I r � y I ! F 3. 4 4. { 14. Special Handling Instructions and Additional Information PROR LE 0 CA006852 9 /� n ZL S tl d-0010 6 ® 9. 15, GENERATORBIOFFEROITS CERTIFICATION: Thereby declare that the contents of this reignited are fully antl accurately described above by the propershlpping name, and are classified, packaged, marked and labeled/placarded, and are in all respects In proper condition forkansport 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 EPAAcknowledgment of Consent. I codify that the waste minimization statement Identified In 40 CFR 262.27(a) (If I am a large quantity generator) or (b) (If I am a small quantity generator) Is We. GeneralorslOffOro s Pont© ra d Na a Signature �T . Month Day Year 9 r � e � = `' r J 16. International Shipments LlImpport to U.S, Export❑ from U.S. Port ofentrylexit Transporter signature (for exports only): Date leaving U.S.: w 17. Transporter Acknowledgment of Receipt of Materials Traner rid edName Sig lure Month D$ay�j Year O YZ ® ® Transport 2Printed/lyped Name Signature Month 1) Ye r H ' 18. Discrepancy 18a. Discrepancy Indication Space ❑ quantity ❑ Type ❑ Residue ❑ PaNai Rejection ❑ Full Refection Manifest Reference Number. 18b. Alternate Facility (or Generator) U.S. EPA ID Number J V LL Facility's Phone: w 18c. Signature ofNternate Facility (or Genemlod Month Day Year Q Z 19. Hazardous Waste Report Management Method Codes (.e., codes for hazardous waste treatment, disposal, and recycling systems) We 1, 2. 3. 4. 2o. Designated Facility Owner or Operator. Certification oirocel ofhazardous materials covered by the manifest except as noted in Item 18a Printedrtyped Name ` Signature Month Day Year EPA Form 8700-22 (Rev. 3-05) Prev seditious are obsolete. DESIGMATlED Fh ,L lilhV TO DESTINATION Sbibb (Vr= REQUIRED)