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Please print or type. (Form designed for use on elite (12-1 typewriter.) Form Approved. OMB No. 2050;0039. <br /> UNIFORM HAZARDOUS 1 , Generator ID Number 2. Page 1 of 3 Emergency Response Phone 4. Manifest Tracking Numberp ry �/( <br /> WASTE MANIFEST CAL00L4t�O6;9i`s"s f ` —:'s"�— 015895839 NJR8 K <br /> 5. Generators Name and Mailing Address Generators SlteAddress in different than mailing address) <br /> ARAMARK LNFORM AND CAREER lAPPAPEL LLC: <br /> 71370 LONGE ST <br /> STOCKTON, CA 9620tJ <br /> Generator's Phone:209-234-0105 <br /> 6. Transporter 1 Company Name U.S. EPAID Number <br /> PHILIP WEST PI DUSTR&/.L SERVICES CAR000177527 <br /> 7. Transporter 2 Company Name U.S. EPA ID Number <br /> 8. Designated Facility Name and SlteAddressU.S. EPA ID Number <br /> C.%-QE(<�@Cryl_ Vi77�STEIt2�6�,��Ef��lEPtt"i INC, C:ATO0n104O117 <br /> 30251 OLD SKYLINE ROAE) <br /> ISEITLEl IAN, CA 0329@ <br /> Facilily's Phone: 800-222=2964 <br /> go. 96. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11 , Total . 12. Unit 13. Waste Codes <br /> HM and Packing Group (if any)) No. Type Quantity WbNob <br /> o t (:s'ON RCRA HA..7ARDOUS "t7VASTE, SOLID 1 CM � .� <br /> z 2. r <br /> w <br /> 3. <br /> RR C <br /> I. <br /> 4. <br /> l r <br /> � I <br /> 14. Special Handling lnstmolions andAddltional Information <br /> PR FE LE * ':.r`4008652 <br /> 15. GENERATOWSlOFFEROR'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, <br /> marked and labeled/placarded, and are in all respects in proper condition for initiation according to applicable international and national governmental regulations. If export shipment and l am the Primary <br /> Exporter, I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. <br /> I unity 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. <br /> GeneratorsfOfferces P tedlFy - Signafure Month Day Year '.. <br /> e � ( , ` � c <br /> -r 16. Intemaiio sial shipments '.. <br /> r ❑ Import to U.S. ❑ Export from U.S. Pad of entry exit: <br /> Transporter signature (for exports only): Date leaving US,: <br /> 04 17. TranspoderAcknowledgment of eceipt of Materials <br /> niter 1 Printed(Typed Name Signal re Month Day Year <br /> ,fres. �� �,. t ✓� a 1� � 17f <br /> G Transporl PdntedlTyp id Name Signature Month Day Year <br /> e- <br /> 18. Discrepancy '.. <br /> 18a. Discrepancy Indication Space ❑ Quantity ❑Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection <br /> Manifest Reference Number: <br /> 18b. Allernate Facility (or Generator) U.S. EPA ID Number <br /> Zi <br /> Z3 <br /> FaciiiVs; Phone: <br /> 18c. Signature ofAllernate Facility (or Generator) - - - Month Day Year . '.. <br /> z <br /> 19. Hazardous Waste Reepod Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br /> 4. <br /> 20. Designated Facility Owner or Operator: Codification of receip of hazardous materials covered by the manifest exceptas noted in Item 18a . - <br /> `II4 Printed(Typed Name r Signature Month [Q�y% a <br /> EPA Form 8700-22 (Rev. 3-0 Previou dRicns are obsolete. BE990MATED rMPLGT ®ESTIIN <br />