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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. GenemtorlDNumber 12. Paqaiof 3. Emergency Response Phone 4, Manifest Tracking Number /y I+IJpp ppp/�/ NJK WASTE MANIFEST �ufALR�t k7uCr 2 84$-334-2008 ® 15 ® 9 5 B 4 5 S. Generators Name and Mailing Address Generators Site Address (if different than mailing address) ' ARAMAM UNIFORM ANC? CAREER APPAREL LLC 76179 LONGE 48T STOCKTON, CA Generators Phow-.�, 6. Transporter i Company Name U.S. EPA ID Number PHILIP VVESTINO 5TRIALS'ERVICES wt^.€2000177527 7.Transporter 2 Company Name U.S. EPA ID Number B. Designated Facility Name and Site Address US. EPA ID Number CHEMU AL WASTE VIN-mIAGEMENT INCA��B7C�PB9 �,7 352459 LLD SKYLINE ROmeD € EfTLEMAN, ;"A x93239 Facili(ys Phoma: 80M22,,2964 9a. 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 Damp (if any)) No. Type Quantity WLNoL R, 0 1. ONqCRA HAZ&Q00LISVVASTE, aOUD �€al � Y _ 4Sg1 _� -- 6 �_. W3. --- G4� € ' 4. yp 4 6 14. Special Handling Instructions and Additional information PROFILEPROFILE # CA008852 � � eJ TT g 16. GENERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described "hove by the pr ershipping name, aM 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 codify that the contents of this consignment conform to the terms of the attached EPAAcknorvledgment of Consent. I cerffy that the waste minimization statement Iden fed in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small qua Qty generator) is We. GenerafoestOferor Printed Nam _ Slgnatur Month Day Year 7 l �i i i� —.r 16. Intemafonal Shipments F_ ❑ Import to U.S. ❑ Fxportfrom U.S. Port of entrykatt: Transporter signature (for exports only): Date leaving U.S.; K 17. TransporterAcknowledgmenf of Receipt of Materials y w Toe erl Printe`�ype area Signature Mont Day YDar 11c, QTmnspoder2 Pdntedrryped Name Month Day ear 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 Facility's Phone: - 18c. Signature of Alternate Facility (or Generator) Month Day Year z N19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, 'and recycling systems) 2. 20. Designated Facility Omer or Operator: Codification ofrece' of hazardous materials covered by the manifest except as noted in gain 18 y PdnfedRyped Name Signature n gMo Oa Year EPA Farm 8700-22 (Rev. 3.05) Pre ous editions are obsolete. DESIGNIATLG FACU u V TO DEST84lPATION STATE (6F REQUOR -B)