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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 Numhertip WASTE MANIFEST CA.LUO04OGG95 U4$-334-24€i3 015895882 �J � 5. Generators Name and Mailing Address Generators SileAddress (if amorentthan mailing address) ARAMARK UNIFORM AND CAREER APPAREL LLC 7079 LONGE ST STOCKTUNI, CA 95200 Generators Phone:2094M-0105 B. Transporter l Company Name U.S. EPA IO Number PHI Li P WEST I NOUSTRIAL SEP11I CES 7. Tmnspoder2 Company Name U.S. EPA ID Number 8. Designated Facility Name and Site Address U.S. EPA ID Number CHEMICAL WASTE MANAGEMENT INC Gs?T00t70409 17 35251 OLD SKYLINE ROAD KETLEMAN, CA 93239 Fadif?a Phone: 1300-222-2904 _ go. 96. 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 WuVol, O 1 ' / CM L.B y _ 41 NON RCRA HAZARDOUS WASTE, SOLI E) � . 3. gfll 4. 14. Special Handling Instructions and Additional information PROFI LE # CA0088612 `O 15. GENERATOR'SfOFFEROR'S CERTIFICATION: I hereby declare that the contents at this consignment are way 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 governments[ regulations. If export shipment and l am the Primary Exporter, I emrtily that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(x) (if I am a large quantity generator) or (b) (ifI am a small quanti a tor) is two. Generators/ fare dbtedl,F •Nam Signature Month Day Year Ir a 16. International Shipments F— ❑ Import to U.S. ❑ Export from U.S. Pad of leaving .S. � Transpodersignalure (for exports only): Dale leaving U.S.: JX 17. Transporter Acknowledgment of Receipt of Materials '.. ua Si ore Month Day Year t2 Tran spo Printed yip Name 3 O W Si ria e Month Day Year '.. Q Transport 2 witedly dName g 18, Discrepancy 189. Discrepancy Indication Space ❑ quantity ❑ Type ❑ Residue ❑ Partial Rejection ❑ Full Rejection Manifest Reference Number: 18b. Alternate Facility (or Generator) US. EPA ID Number '.. U ray. Facllllys Phone: w 18c. SignatureofAlternate Facility (or Generator) Month Day Year Q 19. HazardousWaste Report Management Method Codes (i.e., modes for hazardous waste treatment, dispdsai,and recycling systems) a 1 CU 2 3 4 . 20. Designated Facility wrier or Operator: Codification of race ofhazardous materials covered by the manifest except as noted in Item 1 - PrintedfTypedName Signature sxe Month Da Ye EPA Form 8700-22 (Rev. 3-05) Previous ed ions are Obsolete. DESIGNATED FAC1&, ®EOTINATIGN STATE (IF REQUIRED)