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t 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. Page t of 3. Emergency Response Phone 4, ManlfestTracktng Number - WASTE MANIFEST -Lfl(] 655E5 ' 015895872 JJ K 5, Generators Name and Mailing Address Generators Site Address (if dilferentthan mailing address) ARAIMRK UNIFORM AND CAREER, APPAREL LLC 7075 LONGE ST ' STOCKTON, CA 05206 Generators Phone:209-234`O1 05 6, Transporter 1 Company Name U.S. EPA ID Number PHILIP 'WESTINDUSTRIAL SERVICES 7. Tmnspormr2 Company Name U.S. EPAID Number 8. Designated Facility Name and Site Address U.S. EPA In Number CHEMICAL WASTE MANIAGEMENT INC CATO57L7I0117 35251 OLD SKYLINE ROAD KETTLEI0AN, CA 03230 Facilit/s Phone: f3OM22-2904 ga 9b. U.S. DOT Desorption (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11. Total 12. Unit 13. Waste Codes HM and Packing Group (if any)) No. Type Quantity WtNol. o NON MCRA HAZARDOUS WASTE, SOLID ./� ,'Cul _ 4 1__.k ptp q(q,((( S' f f 4. t 14. Special Handling Instructions and Additional Information PROFILE # CA60S$52 IS14 9VelvIrt T / 15. GENERATOR11OFFEROWS CERTIFICATION: I hereby declare that the contents or this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged, marked and Iabeledlplacarded, 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 EPAAcknowiedgment of Consent 1 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 two. Generator em Printed Nate Signature Month Day Year 16. International ShlpmenteLi Apart to U.S. ❑ Export from U.S. Pod of entrylexit: Transporter signature (for exports only): Date leaving U.S.: '.. K 17. Transporter Acknowledgment of Receipt of Materials '.. Trans As 1 P ' to pe ame11 rSignature Month Day Y a '.. Transport P tedInfirr aMe . Signatures 97 Monh D tay Year K r 18, Discrepancy 18a. Discrepancy Indication Space ❑ Quan0ty [—]Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number. _ iBb. Alternate Facility (or Generator) U.S. EPA ID Number J U ria+. Facility+s Phone: on 18c. Signature ofAllernate Facility (or Generator) Month Day Year Q z 19. Hazardous Waste Report Management Method Codes (i.e., codes forhazardous waste treatment, disposal, and recycling systems) 20. Designated Facilily OwnerorOperetor. Codification of receipt of hazard is materials covered by Ore manifest except as noted in Item Ise Primedflyped Name Signature Month Day Year l EPA Form 8700-22 (Rev. 3-05) Previous editions eobsolete, DESIGNATED FAC.1 LITV XESTINATION STATEI(ni REQUIRED)