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Please print or type. (Form designed for use on elite (12-pitch) typewriter.) Form Approved, OMB No. 2050-0039 '.. U1I10RMNAPARD0US 1. Generator ID Number2. Pagel of 3. Emergency Response Phone 4. ManifestTractdng Numberp ry �p WASTE MANIFEST CAL 0 0 0 4 0 6 !n' 'i ( „60) 4 24- C:30 011178626 NJ811 K S. Generators Name and Mailing Address Generator's SimAddress (itamerenithanmailingaddress) " ARAMARK 7079 9, LONGE ST. OCK T[Slit C'A, Q.6200 Generators Phone: i 200) X-E-V 1 5 - 6. Tra s oder1 C any Na U,S EP OIL 7. Transpoder2 Company Name U.S. EPA ID Number 8. Designated Facility Name and Site Address U.S. EPA ID Number ❑HEMI CAL MS T E ts1ANs=.G EIVIENT, INC. 352151 OLD SKYLINE ROAD v- A T 071 0 6 46 1 1 T KETTLS=M SICBTYCArX239 Facility's Phone: ( 65G) H& 9711 Ga. 9b. U.S. DOT Descdplion (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11. Total 12. Unit 13. Waste Codes HM and Packing Group If any)) F No. Type Quantity Wtivoi. 1. 4�,QN I?C:RAIH:Z GC1LIS YVASTE SOLID 4731 o 3. 4. �p 4 14. Special Handling Instmckons and Additional Information®f `' CACE09852 CHEfwATREC C�}NTR' ;�C:i PCCN24. 11 ' 15. GENERATOR'SIOFFEROWS CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above bythe propershlpping name, and ate classified, packaged, marked and labeled/placarded, and are in all respects In propercondition for transport according to applicable intemalionaland national governmental regulations. If export shipment and I am the Primary Exporter, I car ily 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(a) (f I am a large quantitygenemtar) or (b) ('di am a small quantity generator) is We. GenemtoralOge PAle Nam "` Signature Mon 0 FEP 16. Intematianal Shipmne je ❑ ImpadoU.S. ❑ Export from U.S. red of entry/exit: Transporter signtore (forexports only); Date leaving U.S.: w 17. TranspoderAcknoMedgmentofReceiplof Matedals n Tense dnl d!f ed me Sign . Month Day GO Year ® l Month Da Year B Tmnspor2Pnnied(ryp Name Signator y ce F— n 18. Discrepancy His. Discrepancy Indication Space ❑ Quantity ❑ Type Ll Residue ❑ Partial Rejection El Full Rejection Manifest Reference Number: 18b. Alternate Facility (or Generator) U.S. EPA ID Number J U Facilli Phone: 18c. Signatue of Alternate Facility (orGeneralor) Month Day Year 19. Hazardous Waste Report Managements®Mpethod Codes (i.e., codes forhazardous waste Irealmenf, disposal, and recycling systems) ® I. 4 20. Designated Facility Ormeror Operator: Certification of receiptof hazardous materials covered by the manifest exceptas noted in Item 1ga ar Pdnted/fyped Name Signature Mon ` Day Y/e A EPA Form 8700-22 (Rev. -05r revious a ions are obsolete. DESIGNATED FACILITY TO D STINATION STATE (IE R MIRED)