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Please print ortypo. (Form designed for use on elite (12-pitch) typewriter.) Form Approved. OMB No, 2050-0039 <br /> 4. Manifest Tracking Number <br /> UNIFORM HAZARDOUS 1. Generator ID Number 2. Page 1 of 3. Emergency Response Phone <br /> WASTE MANIFEST CAI-©1-L1d05` L5 � �"� ' '�®� 0 1 5895879 �� <br /> 5. Generators Name and Mailing Address Generators Site Address to dilferentthan malting address) <br /> ARAMARK UINII FORM AND CAREER APPAREL. LLC <br /> 7070 LONGE ST <br /> STOCKTON, CA 05206 <br /> Generators Phone:2�E23Q'L11 ®5 U.S, EPA ID Number '[ <br /> 6. Transporter 1 Company Name <br /> P's-14LfP WESTtNC?LlSTRIAL SERVICES <br /> U.S, EPA ID Number <br /> 7, Transporter 2 Company Name <br /> 8. Designated Facility Name and Site Address U.S. EPA ID Number <br /> CHEIa4E.CAL NAIASTE MANA�°EMENT INC CAT000646117 <br /> 35251 Ol.O SKYLINE ROAD <br /> €;ETTLEMAN, CA 0323E <br /> Facill(/a Phone: 0800-222-20 <br /> 9b, U,S. DOT Description (including Proper shipping Name, Hazard Class, ID Number, 4g, Containers 11. Total 12. Unit 13. Waste Codes <br /> 9a' No. T Quanfily WI.N01. <br /> HM and Packing Group (if any)) Type , <br /> 1' NON RCRA HAZARDOUS WASTE, SOLID $ CM � � d _ _ _R ��1 <br /> 2. 4' <br /> 4. <br /> tl <br /> 14. Special. Handling Instructions and Additional Information <br /> PROFILE 4 CA50EE52 <br /> 15, GENERATOR'SIOFFEROR'SCERTIFlCATION: I hereby declare that the contents of this consignment are fully and accurately rescreen above by the proper shipping name, and are classified, packaged, <br /> marked and labelediplacarded, and are in all respects in proper condition for transport according to applicable Interactions] and national governmental regulations. If export shipment and I am the Primary <br /> Exporter, I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgmenl of Consent. <br /> I certify that the waste mmlml tate ent idenbiged in 40 CFR 262.27(a) (if I am a large quantity genemlo) or (b) (if I am a small quantity generator) is We, <br /> Signature Month D y Year . <br /> Genuratorsl0( ors P ' tedR d e ` /G'�_' <br /> F 16. International shipments LlImportl S. ❑ Export from U.S. Port ofentrylexiC <br /> Z Transporter signature (for exports only): Dale leaving U.S.: <br /> W 17. TmnsporterAcknowledgmantof Receipt of Materials Month Day Year <br /> Tons oder 1 Pnnted/Typed Name Signature <br /> z Transporter rine ped Name Signature Month Day Year <br /> a <br /> 18, Discrepancy <br /> 18a. Discrepancy Indication Space 0 Quantity ❑ Type ❑ Residue ❑ Partial Ruination ❑ Full Rejection <br /> Manifest Reference Number: <br /> 18b. Nlemate Facility (or Generator) U,S. EPA ID Number <br /> J , <br /> U <br /> <. Factitys Phone: Month Day Year <br /> Ow 180. SlgnatureofAllemale Facillly (or Generator) <br /> 6 <br /> Z <br /> 19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br /> ® 1. 2. <br /> 3, 4. <br /> 20, Designated Facility Owner or Operator. Certifica8on of n:ceipt of hazardous materials covered by the rearrest except as oder in item 18a Month Day Ye <br /> Prato ype l Name - Signature <br /> EPA Form 8700-22 (Rev. 3-05) Pre ouseditionsareobsolete. I�E�E�EVE�SED FACIL v 0 DESTINATION STATE (IF NE®DIDED) <br />