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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 I . Generator ID Number 2. P e 1 of 3. Emergency Response Phone 4. Manifest Tracking Number pp WASTE MANIFEST C:ALCt�3D�aC�5595 844" 334-2498 1015895850 NJJ K 5. Generators Name and Mailing Address Generators Site Address (if different then mailing address) APAMARK LINIH'CRNI ARC1 CAREER APPAREL LLC 7679 LONGE ST MCKTGtN, CA 9529E Generators Phone:28'0-224-8') 05 6. Transporter l Company Name U.S. EPA ID Numbe PHILIP WEST INDLI_MAL SERVICES 4,® A�- a'_'5 1 7. Transporter 2 Company Name U.S. EPAID Number 8. Designated Facility Name and Site Address C .S. EPA ID Number h{EI�kICAL 'b7fA5TE MANAGEMENT INCIRC C,�T 4�Lf17131Ei € 1T 35=251 OLD SKYLINE ROAD KEETTLEMMI, CA 93239 Facility's Phone: 0OLM-29E4 ''.. ga 96. U.S. DOTDescdption (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers it. Total 12. Unit 13. Waste Codes HM and Packing Group (If any)) No. Type Quantity Wt.N01. g o CEGB FICRAHAZARDOUSYVASTE, SO ICI � CIA 16 Y4- ^ 119'7,_ g!'_ w 2. 4. -- � TT qq 14. Special Handling Instructions and Additional Information PR IFILE0 CA608862 15. GENERATOR'SIOFFEROR'SCERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping naersd, arxj are classifled, packaged, marked and labeled/placarded, and are in all respects in proper condition fortransport 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 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 quantityaerator) is line. Generatorsl0 rs Pdt p Nie Signature Month Day Year 119112 J 16. International shipments i— import to tis. ❑ Exporttrom U.S. Pod of entry/exit: z Transporter slgnature (for exports only): Date leaving U.S.: IL 17. TranspoderAcknowledgment of Receipt of Materials j Transporter 1 Pdntedflyped NameSigna Month Da Year e� 2 Transporter2Printe yped Nam Signature Month y Y r rY H 18, Discrepancy 18a. Discrepancy Indication Space ❑ Quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number: 181h. Alternate Facility (of Generator) U.S. EPA ID Number V w Facility's Phone: " w 18c. Signature ofAltemate Facility (orGenerator) Month Day Year � I y19. Hazardous Waste Repad Management Method Codes (I.e., codes for hazardous waste treatment, disposal, and recycling systems) 2. 3. 4. 20. Designated lily Overerar Operator: Ciall lion of iecelt of hazardous materials covered by the manifest except as noted in Ile 18a Printedffyp Name Signature Me Day Year EPA Form 8700- 2 (Rev. P5) Previous editions are obsolete. DIE9NG6lATir=0 PACIRBpYTO iF—STRMXf &M hADLE IfW WWIln �®