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I print 74 Par; Wd F se � 1 (1'2 ) typewriter.) lease riot e. orm ned fo useo II - cForm Approved. OMB No, 2050-0039 UNIFORM HAZARDOUS 1. Generator ID Number 2. Paggp 1 of 3. Emergency Response Phone 4. Manifest Tracking Number WASTE MANIFEST CAL000LI055$a 1J h'*1• — � '24€3 ' 015 8 9 5 8 7 8 A 5. Generators Name and Malllog Address. Generators Site Address (if different than mulling address) ARAMARK UNIFORM APJD CAREER APPAREL LL C" 7679 LONGE ST STOCKTON, CA, 95206 Generators Phone:209_2^344_0106 6. Transporter 1 Company Name - U.S. EPA ID Number PHILIP WEST INDUSTRIAL SER./ICES CAR000177527 7. Transporter 2 Company Name U.S. EPA ID Number 8, Designated Facility Name and Site Address U.S. EPA ID Number CHEMICAL \A/ASTE MANAGEMENT INC CAT000046117 35251 OLD SKYLINE ROAD KETTLEMAN, CA 93239 Facility's Phone: 8000 222-29674 ga 9b. U.S. DOT Description oncluding Proper Shipping Name, Hazard Class, ID Number, 10. Containers it. Total 12, Unit 73. Waste Codes HM and Packing Group (if any)) No. Type Quantity Wt./Vol. v t NON RCPAHAZARDOUS WASTE, SOLID 1 CM V 4eqs 91J i CD CD 2' i { 3. ! I 4. I 14. Special Handling Instructions and Additional Information Q$ PROFILE # CA608862 AMD i P(IZ P7 15. GENERATOWSIOFFEROR'S CERTI C ION: I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name, andl 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 codify that the contents of this consignment conform to the terms of the attached EPAAcknowledgmenl of Consent. I certify that the waste minlmkzafion statement I mified In 40 CFR 262,27(a) (if I am a large quantity generator) or (b) (fl am a small quantity generator) is true. Generators/Offer riot yps Signature _, Month Day Year --e 16. International Shipments i— ❑ Impartio U. . ❑ Exportfrom U.S. Port of entry/exit: Transporter signature (forexports only): Date leaving U.S.: w17. TransporterAckn wkedgment ipt of Materials Tran orter 1 Pdntedlfyped Nam Signator Month Day Year t� - t QTransporter 2 Printed yped Name Signature > Mon Day Year f- .Ip 18. Discrepancy I 18a. Discrepancy Indication Space ❑ Quantity ❑Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number: 18b. Alteroate Facility (or Generator) U.S. EPA ID Number J U e+a- Facllity's Phone: w 18c. Signature ofAltemate Facilily (or Generator) Month Day Year 4 z U5 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) 4. 20. Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as noted In Item 18a Pnntedfryped Name Signature Month Day Year A c s v fl EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolete. DESIGNATED FACILITY TO DESTMATIOM STATE (OF REQUORED)