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i I Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved. OMB No. 2050-0039 UNIFORM HAZARDOUS 1 , Generator l0 Number 2. Page 1 of 3. Emergency Response Phone 4. Maniteat Trucking Number p WASTE MANIFEST C�o3,LOL0405s9fi 844-334-2408 015895875 5 JJ K 5. Generators Name and Mailing Address Generators Site Address (if different than mailing address) ARANIARI4 UNIFORM AND CAREER APPAREL LLC 7079 LONGE ET STOrKTON, CA 45200 Generators Phane:209-234-0105 6, Transporter 1 Company Name U.S. EPA ID Number PH.ILIP 'WEST INDUSTRIAL SERVICES CAR000177527 7, Transporter Company Name U.S. EPA ID Number 8, Designated Facility Name and Site Addressqt U,S. EPA ID Number CHEMICAL WASTE MANAGEMENT INC CATr700046117 25201 OLE) SKYLINE ROAD KETTLEMAN, CA 93289 Facility's Phone: 800-222-2904 1, ga. 9b. U.S. DOT Description (including ProperShipping Name, Hazard Class, ID Number, 10. Containers 11. Total 12. Unit 13. Wase Codes HM and Packing Group (If any)) No. Type Quantity Wt.Nol, 1. €€ R NON RCRA HA7A-RDOUS WASTE, SOLID CM � � i' _ 1491`1 z 2. CD w _=a.. 3. r �i 14. Special Handling Instructions and Additional Information ` i'liAOL " 306"8`D V PROFILE # CA608852 � felwl � aE) S�J � e gP ` s3 � � fs�nif Oil 15. GENERATOR'SIOPFEROR'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 labeled/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 Exporter, I certify that the contents of ihls consignment conform to the terms of the attached EPAAcknowledgment of Consent. I cadify that the waste minimization statement identified in 40 CFR 26227(a) (If I am a large quantity generator) or (b) (if i am a small quantity generator) Is We. GeneratorslOffeners rinledff but e / Signature Month Day Year --r 16. Intemabonal hipmems; i- ❑ Importto LLS ❑ Export from U.S. Part ofenkylexit Transportersignature (for exports only): Date leaving U.S.: w17. TransporterAdmowledgment ofRecelpl of Materials Transporter 1 Pdnted/fyped Name ��y Signature Month Day Year M Transporter Pnntedilype Name Signature Month Day Year t- 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 3 V ras- Facifflyzs Phone: w 18c. Signature of Alternate Facility (or Generator) Month Day Year B z y19. Hazardous Waste Report Management Method Codes (0., codes for hazardous waste treatment, disposal, and recycling systems) a 1. 2. 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Pdnte( /fyped Name Signature Month Day Year � Ar 03 D5 EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTINATION STATE (IF REQUIRED)