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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. Pa 1 of 3. Emergency Response Phone 4. Manifest Tracking Number pp pp ��(( WASTE MANIFEST C',A?QQQ+�Q55C-s5 Q—:33�.-'21 015895843 NJRJJ K 5. GenuraWs Name and Mailing Address Generators Site Address (if different than mailing address) ARAMARK UNIFORM ANO CAREER APPA EL LLC 7679 LONGE ST STOCKT(7N, CA 962063 Generators Phone:2094--01135 B. Transporter l Company Name U.S. EPA ID Number PHILIP WEST INDUSTRIAL SERVICES CAR1IQQ `: • 9 T' ) b 7. Transporter 2 Company Name U.S. EPA ID Number B. Designated Facility Name and Site Address U.S, EPA ID Number ',, CHEMICAL WASTE €A,NAGEME IT INC CAT000040117 35251 OLD SKYLINE ROAD KEIT! LF_MAN, CA 9323 Facility's Phone: 8001-222-2904 ga gb. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Contalners 11, Total 12. Unit 13. Waste Codes HM and Packing Group (if any)) No. Type Quantity Wt.Nal. ',. 1. NON Rc.RA HAZARDOUS AA>`:>ASTE. SOLID Y � " _1 213 _b� o * k 2. & €' LU p f 4. tl ( P' 14. Special Handling Instructions and Additional Information PROFILE 0 CAE-08852 o l 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 labeledlplacarded, and are In all respects in proper condition for transport according to applicable international and national governmental regulations. If export shipment and am the Primary Exporter, I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consort. I certify 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 fore. Genemmesl0� PgBfedffyp W Signature MonDay Year 0 L�7/ .--i 16. International Shipments F ❑ Import ( U.S, ❑ Export from U.S. Port of entry/exit: Transporter signature (for exports only): Date leaving U.S.: IX 17. TransporterAcknowledgment of Receipt of Materials E2 Transpor(eri Pdntedflyped Name Signator Month Day Year a F USG r G Transpader2 Panted7fyped Name "' alu Month My Ye K r— 18. Discrepancy 18a. Discrepancy Indication Space ❑ Quantity El Type ❑ Residue ❑ Partial Rejection ❑Full Rejection Manifest Reference Number: 18b. Alternate Facility (or Generator) U.S. EPA ID Number J U rat Facility's Phone: w 18c. Signature of Alternate Facility (or Generator) Month Day Year 6 y19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) 2. 3.. 4 20, Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted In Item Ise Prinledlfyped Nam n r /'� ^ Signature Month Day 1 Year EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. I`./ V ESIGINIA E ,D QACILITY TO DESTiNA-VIGH smm (0v REQUIRED)