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Please print.or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved. OMB No: 2050-0039 <br /> UNIFORM HAZARDOUS 1. Generator ID Number 2. Pae 1 of 3. Emergency Response Phone 4. ManifestT acking Number <br /> WASTE MANIFEST "v- -C��'� r� '� 844-334-240801 895858 JJ K <br /> 5. Generator's Name and MallingAddress Generator's Site Address (if different (ban mailing address) <br /> ARAMARK UNiFOM0 AND CAREER APPAREL LLC <br /> 7@79 LONGE ST <br /> STOCKTON, C`?; 95206 <br /> Generator's Phone:209-234-9195 <br /> 6. Transporter 1 Company Name U.S. EPA ID Numbera49 ; <br /> PHILIP VIEST I NDL1S T DIAL SER ICEm <br /> 7. Transporter 2 Company Name U.S. EPA ID Number <br /> 8. Designated Facility Name and Site Address WA <br /> GU.S. EPA ID Number <br /> &�Efv?1C.1�L '�TEPv3APalA0Er;3EP�STiNC CATP3t�C6459i7 <br /> 35251 OLD SKYLINE ROAD <br /> KETI ,ENAAN , CA 99239 <br /> Facility's Phone: ',800I 262-29574 <br /> ga ft 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 Quard fy Wt./Vol, <br /> 1. <br /> NON RC€?A HAZARDOUS WASTE, SOL€ D0 / C� 22 491 —�� <br /> W 2' <br /> V. <br /> 3 pgL <br /> 4. I <br /> 14. Special Handling Instructions and Additional Information li <br /> PROF! LE = CA6088v2 <br /> 15. GENERATOR'SIOFFEROWS CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, and h classified, packaged, <br /> marked and Iabeled(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 <br /> Exporter, I codify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. <br /> I certify that the waste minimization statement identified In 40 CFR 262.27(a) (if i am a large quanlify generator) or (b) (ifI am a small quantity generator) Is true. <br /> Gonemiors(08erc Ponte p dNa " Signature month Day Year <br /> —r 16. International Shipments <br /> F— ❑ Import to U.S. ❑ Export from U.S. Port of entry/exit. <br /> Transporter signature (for exports only): Date leaving U,S.: <br /> Do 17. Transporter Acknowledgment of Receipt of Materials <br /> Transport r 1 Prints ee Sig] .,;� - MonthDay Year <br /> O <br /> CL <br /> QTransporter Primed Ry ed Name SignaWr Month Day Year <br /> 18. Discrepancy <br /> 18a. Discrepancy [beheaded Space ❑ Quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection <br /> Manifest Reference Number: <br /> 18b. Alternate Facility (or Generator) . U.S. EPA ID Number <br /> J_ <br /> rB+. Facility's Phone: '.. <br /> out 18c, Signature ofNternefe Facility (or Generator) Month Day Year <br /> Q <br /> 19. Hazardous Waste Report Managem <br /> ent Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br /> O 1 GJ 2. 3. 4. <br /> 20. Designated Facility Owner or0 orator. Codification of receipt ofhazar ous materials covered by the manifest except as noted in Item 18a <br /> Pdntedflyped Name SignatureMo ay Year <br /> EPA Form 8700-22 (Rev. 3-05)-Previous editi are obsolete. M,L� 9��ATL� ACfiLpT E�41611ATION STATE (9F REQUIRE <br />