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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 hone e 1 of 3. Emergency Response P 4. Manifest Tracking Number p pp WASTE MANIFEST C. 47�t]'4L�5595 �4 334-m4G`t', ® � 95851 g7JJ1 pp;{//Sal 5. Generators Name and Mailing Address Generators Site Address (if different than mailing address) ARN4ARK UNIFORM AND CAREER APPAREL LLC. 76_s7f] LOGE ST STOCKTON, Cts, 95200 Generators Phone:209•-234.-01 005 6. Transporter l Company Name U.S. EPA ID Number �® PHILIP V�J;EST INDUSTRIAL SERVICES ' 7. Transporter 2 Company Name U.S. EPA ID Number 8. Designated Facility Name and Site AddressU.S. EPAID Number CHEMICAL ` VAISTE 11,4ANAGERiEN _ INC C'A1000646117 35251 OLD SKYLINE ROAD KETTLEt;lliaikJ, CA 63239 Facility's Phone: 800-222-2984 ga 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Contalnso 11. Total 12. Unit 13. Waste Codes HM and Packing Group (ifany)) No. Type Quantity WWoL Np ® NON tCPf. HAZARDOUS J1IRSTE , SCILID Y �_ 491 N 'see - I---- --- 2. -- -2. pp 41 14. Special Handling Instructions and Additional Information PROFILE 4CAI 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. .tf export shipment and I am the Primary Exporter, I cerfily that the contents of this consignment conform to the terms of the attached EPAAcknmvledgment of Consent. I certify that the waste Inimizatlon 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 two. General III rs Pd E yped Nam - Signature Month Day Year ! 71 J 16, International Shipments t- ❑ Imil to U.S. ❑ Expad from U.S. Pad of entry/exit: Transporter signature (for exports only): Date leaving U.S.; w17. TransporterAcknowledgment of Receipt of Materials i2 TransPrinted/Typed Name Sig a Month Day Year O 019 IP71 Trans ter Printedity ed Name Signet ' kill Day Y r F- 18. Discrepancy 18a. Discrepancy Indication Space ❑ Quantity 11 Type ❑ Residue ❑ Partial Rejection Ll Full Refection Manifest Reference Number: 186. Alternate Facility (or Generator) U.S. EPA ID Number J U LL Facility's Phone: w 1So. Signature at Alternate Facility (or Generator) - Month Day Year B 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste Vestment, disposal, and recycling systems) ® 1. 2. 3. 4.) 20. Designated Facility Owner or 0p rotor; Certification of receipt of h rdous materials covered by the manifest except as noted in Item 18a Printedfiyped Name Signature Month Day Year EPA Form 8700-22 (Rev. 3-05) Previous elfifirafs are obsolete. DEMIGMATED FRCP o . 1® BE'sTo639A I STATE (@F REQUIRED)