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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. Page 1 of 3. Emergency Response Phone 4. Manifest Tracking Number WASTE MANIFEST C.�I P�S� � �� .�-35 —21�as 015895873 JJ K S. Generator's Name and Mailing Address Generators Site Address (if different than malting address) ARA6v'IARK UNIFORM AND CAREER APPAREL LLC 7079 LONGE ST STCCKTCN, CA 95200 Generators Phone:2M234-01 05 6. Transporter I Company Name U,S, EPA ID Number ®a' zTOY PHILIP WESTIN®LIS'MMALSERVICES 4 � . "—7 7, Transporter Company Name U.S. EPA ID Number 8. Designated Facility Name and Site Address U.S. EPA ID Number CHEN41CAL WA9'1M ~GEMENT INC C�T3t1��fI�117 35251 OLD SKYLINE ROA KE I'LEMAN, CA 93239 Facility's Phone: S[Y.f4 22-•2964 go. 9b. U.S. DOT Description (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 WiNol. 1. o NON IRCRA h{>ZARDOLIS WASTE, SOLID Y �m r_ t 491 _1 -- 3. i gyM f 4. 14. Special Handling instructions and Additional Information PROFILE # CAS`8852 15, GENERAT0R'S10FFER0R'S CERTIFICATION: I hereby declare that the contents of this consignment pro fully and accurately described above by the proper shipping name, and are classified, packaged, Ili marked and labelediplacarded, 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 rarity that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. I ceully that the waslo minimization stateme t idenfifiefi in 40 CFR 262.27(a) (if I am a large quanplp generator) or (b) (fit am a small quanfl orator) is We, GeneratorslOHerorsintedlTd Name - Signature / Month Day Year 12 11 qJe J 16. International Shipments - ❑ Importto U.S. ❑ Expodfrom U.S. Pod of entry/exit: Transporter signature (for exports only): Date leaving 4S.: W17. TranspoderAcknowledgment of Receipt of Materials Trans orter 1 Printed/Typed Name Signature / Month Day Year z17. 1 A I 1 BTranspoder2 Prmeanyped Name Signature Month Day Year F 4. 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 U LL Faciiity's Phone: w fits. Signature ofNtemate Facility (or Generator) Month Day Year Q ' Z i 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal,and recycling systems) w 1 2. 3. 4. 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a ! Printed/fyped Name Signme Month Day Year D EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete, ®ESOGNATEO FACILIPTYTO DESTINATION STATE (IGS REQUIRED)