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Pleaserintor type.. ER �IIII �IuII�) �I� � pForm 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 CAL00ti�; 69845 1 (877) 577-266`3 014027409 FLE 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) 99 Cents Only #177 99 Cents Only#177 (209) 956-4992 1120 E. Hammer Lane 1120 E. Hammer Lane Generator's Ph one: Stockton CA 95210 Stockton CA 95210 6.Transporter 1 Company Name U.S.EPA ID Number Solutions MNSO 1110 924 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address General Environmental Mgt, LLC U.S.EPA ID Number 11655 White nock Road I Rancho Cardona, CA 9574;7 Facility's Phone: 9a 9b.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.Nol. o X bN1950, Waste Aerosols, [flammable, (each not 1 CF 000tr"�E: F' 214 D001 0 exceeding 1 L capacity)] (Aerosols), 2. 1. -- z 2. UJ t9 3. 4. 14.Special Handling Instructions and Additional Information 1. 101998(Aero s o 1 s i 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 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 certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is We. Generator's/Offeror's Printed/Ty6ed Nae a Signature Month Day Year On alf f 9. Cents Only Dc►'�'tom, � 08 18 202 16.International Shipments [= ❑Import to U.S. ElExport from U.S. Port of entry/exit: ? Transporter signature(for exports only): Date leaving U.S.: I=117.Transporter Acknowledgment of Receipt of Materials 1 Transporter 1 Printed/Typed Name Signature / r Month Day Year a Jared Marcie,". r, �/C._.�� 1 081 18 202 Transporter 2 Printed/Typed Name Signa re Month Day Year rr 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: F 18b.Alternate Facility(or Generator) U.S.EPA ID Number L) LL Facility's Phone: w 18c.Signature of Alternate Facility(or Generator) Month Day Year Q Z N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) G 1. 2. 3. 4. 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest fxcept 0 noted in Item 18a Prin /Ty d Name ` ` Signatu a Month Day YeaL EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM 8700-22 12v3 CAL4 13WW., S40628263 041856999 M P D 0 8 i 8;_`0 =D081 Bc:0