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aes5e mrd or type (Form desigred for tsse on eft(12-pitch)typevrnier) f=orm AVpmwed OMS No 205MMS <br /> UWORMHAWOO- 1 Cer'& t0 Number 2 ?age 1 of 3 EmeBaure y Respv%se?fg41lanFfestTrackin Number <br /> WAM UAIUFM 1 877577266 <br /> 9 01(38 7011 F LE <br /> Nr xc S'asrg a� <br /> g pdOCss(it drf rOrM tlran maf e¢,I ad�iss, <br /> Bath & Body Works 1510 Bath & Body WorksU510 <br /> 2094729339 4950 PACIFIC AVE, WEBERSTOWN MALL/ SPICE 495® PACIFIC AVE <br /> I, r a�rS Ptxx STOCKTON, CA 95207 ST[3CFCTON, GA 95207 <br /> t c ar x*+YMericycle <br /> US EPA 10 NWIW <br /> Specialty Waste Solutions Inc X0110924 <br /> 7 2 Com-f Name US EPA C Nl IN- <br /> Worldwide Recovery Systems CARM175422 <br /> peygn3ledFac�&wName amd Stte A6OBnYuma Yes, LLC US EPA ID Nur oer <br /> 27-30 E. 13th Street <br /> Yuma, AZ 85.65 <br /> Facit�5 PMhG � <br /> 9a %U S ROT DEQ i#-(fttdl*g Proper Sttq fora,F=ord 0es,10`3ar1ba. 10 Cakau ers 11 Total 12 Lkt4 3 Mid Codes <br /> ( and dada g Grotp(E any)y am Typo oua n j wi tart. <br /> cc 1 Non RCRA hazardous waste, liquid (Soaps, 1 DF 00092 G 331' 1 <br /> 0 Lotions),Uj <br /> , <br /> z z <br /> 3 <br /> a <br /> 14 Sped Havim9 F x and m6ovi l hfimtason 1. 1109 2(State Regulated Liquids) <br /> 15 CENERATOR'SJOFMMR'S CFRTIFICATION: I hereby detkre tat the tont Z Of tts cursqrrIRr aro kiy and aCpXfty described*v a try ft vwvr 3N name.,i d are dammed,padr3gec, <br /> marked and Wbdedrblacarde and are o ad rexem N Kum r"Zm l r nra on ae Jrg b aPO taw hE amd wbor=Zcot' <br /> tidr5;exw stuweri and I amr ft%may <br /> 6pttxt. a"tf Trot Uv mrderrts of ahs Wr4gvTR t mrkrm to 6t mm of se aMKhed EPAAcVC Ae43ment of Com <br /> f (y 2nt wastci min stmvwj din 4O CFR 262 27(a)(d f am a"4",$y PM Mtt7r}or t(b)M 1 sm a small rue <br /> si �Print ype�Nar"e rerukd <br /> i e <br /> rlU <br /> J 1E *.,m SNV� F]irmonm 5 n Export trx+1 U S Pct of erwyyAia <br /> ? Trmx skmamm k? rxd i, Date' U S <br /> 17 T arm wciax nary tt Rec�pt d 1+4e1s <br /> TrarvKorW T PmV G 5W Name mature- YC-4 <br /> cc <br /> mKristooher Almanza kUrtri Day row <br /> r <br /> 1®Owepancf 1 ( <br /> 18a Dscrepar y'dcxdonSoace j I laity ITyx E�;�ue l.,�Pat.Pejea. `jFLjoReown <br /> Ik i6^4 W artrce NrarAw: <br /> 1 Et Aftmvte Facky rcr Gorlrrjt5f) U S.EPA ID Nrarber <br /> J_ <br /> 0 <br /> Q <br /> :5 Faalrtl/s Phov i <br /> w tik:Slcnamre d F=cy(or C�ener"O hionm Day tea <br /> r- <br /> a <br /> Z <br /> 19 HY'3rd0us Washe Raped Wrogenwe Vattvd Codes Q a,t3de3 for hazardous wasle treatMWL jsposoL and recydng sysamm) <br /> UJ 2 3 4 <br /> �LA l <br /> 20 Denria=Faa ty LAww or CparaOr CvrAt:; ton of receipt of fa=rdous mawmr s=�Wvd*t1 mandest except m IWm 18a <br /> PW Na" Sgn7tue 1 kKN4 Day Vaar <br /> V 0— G <br /> EPA Form MO-22(Rev 3.05) Precious editions are obwiete. D1 7 D erACE1 11V TO DFri T1NAT'ION' TATE (;F RE'QU1RF 7) <br />