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I 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-AL0004135505 I 844'3 2408 015895877 JJ K. 5. Generators Name and Mailing Address Generators Site Address (if than mailing address) A.RMOARK UNIFORM ASVD CAREER APPAREL LLC � rST rv�c 95285 . Generators Phone:2Q9-2ZI4-]A05 6. Transporter i Company Name U.S. EPA ID NumbetlffkhO e 459. 69 ; y 0 PHI LI P 1tVESTINE)USTRIAL SERVICES 0 7, Transporter 2 Company Name U.S. EPA ID Number i 8. Designated Facility Name and Site Address U.S. EPA ID Number CHEMICAI. 1fkWS i E MAf`JAGEMENT INr C-AT4tOD046117 35251 OLD SKYLINE ROAD KETTLEMAR3, CA 99230 Faci f es Phone: 83709-222-2064 ge, 91c. 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 Wt.NOI. 0 1 NIX4 RCRA HAZAPDOUS UVASIE , SOLID 1 CIUi y Y - 409 cfi f y t w t 3. i ) f f 14. Special Handling instructions and Additional Information Tit- t' P13F747 PROFILE4- CA608852 iL(!t av 6a 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 labelediplacarded, and are in all respects in proper condition for iranspon according to applicable international and national governmental regulations. If export shipment and I am the Primary Exporter, I codify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. I certify that the waste minknizationistalisment Identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (If I am a small quant) generator) is tme. Generatoes(Ogerors Prince ped m Signature Month Day Year —5 16. International Shipments F— 1 ❑ Import to U.S. ❑ Export from US. Port of entry/exit: z Transporter signature (for exports only): Date leaving U.S.: CK 17. TransporterAcknowiedgment of Receipt of Materials ' Transporter 1 Pnmedffyped Name Signature Month Day Year �at,. t4�* � 3 ti � 3 3 Transporter 2 Printeffyped Name Signature Month Day Year F- 18. Discrepancy - 18a. Discrepancy Indication Space ❑ quantity []Type Residue ElPartial Rejection ❑ Full Rejection Manifest ReferenceNumber. iBb. Al mate Facility (or Generator) . U.S. EPA ID Number J U r¢+. Facility+s Phone: w IBc. Signature of Alternate Facility (or Generator) Month Day Year Q y19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal,and recycling systems) 3. 4. 20. Designated Facility Owner or Operator: Cedifcaon of receipt of hazardous materials covered by the manifest except as noted In Item i8a Prtnted7ryped Name Signature Month Day Year IDS 11 2� 1l EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. DEsi aIR4mm rAcO g TY TO DESTINATION STATE (OF REQUIRED)