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Please print or type.(Form designed for use on elite12- itch t ( 2-pitch)typewriter.)) Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 1 3.Emergency Response Phone 4.Manifest Tracking Number WASTE MANIFEST CAL000427616 1 8775772669 010788995 F L E 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) Bath & Bodv Works 1510 Bath & Body Works#1510 094729339 4950 PACIFIC AVE, WEBERSTOWN MALL/ SPACE 4950 PACIFIC AVE Generators Phone: STOCKTON, CA 95207 STOCKTON, CA 95207 6.Transporter 1 Company Name U.S.EPA ID Number Stericycle Specialty Waste Solutions Inc MNS000110924 7.Transporter 2 Company Name U.S.EPA ID Number ry �✓ r'�� .e iso 9-�i oma- NOv !�-d'V 3 k 2-133 8.Designated Facility Name and Site Address Clst Century EMN, LLC U.S.EPA ID Number 2095 Newlands Dr. East Fernley, NV 89408 Facility's Phone: 775575760 NVD980895338 9a. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit HM and Packing Group(if any)) 13.Waste Codes No. Type Quantity wt./Vol. 1. UN1993, Waste Flammable liquids, n. o. s. (Ethyl 1 DM 00044 P 331 D001 U00 0 Alcohol, Acetone), 3, PG II, ERG#128 -- - w �' V 2. UN1950, Waste Aerosols, [flammable, (each not 1 CF 00019 P 331 D001- exceeding 1 L capacity)] 2. 1, ERG#126 ----,---`: -- 's 3. I ) { i 4. t 14.Special Handling Instructions and Additional Information 1. 110905(Flammable Liquids) 2. 110904(Aerosols, Flammable) 15. GENERATOR'SfOFFEROR'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 labeledlplacarded.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 EPAAcknowledgment 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 true. rator's!0 eror s Printe Gened/Typ ame Signaturf RCL r e n i f O f L l m l t e Monthay ear 04 01 201 -t 16.International Shipm nts ❑import to U.S. ❑Export from U. Port of entry/exit: Transporter nature for exports P Date leavin U.S.: w 17.Transporter Acknowledgment of Receipt of Materials Transporter 1 Printed/ryped Name gnature Mont ay ear a Johnn Har er CIO0� 091 201 Z Transporter 2 Printed/Typed Name Signatu 9 Month Day Year 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection El Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U a LL Facili 's Phone: w 18c.Signature of Alternate Facility(or Generator) Month Day Year a Z rn 19.Hazaido.us Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) p 1 (-i 1,, 3. 4. 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed/Typed Name Off) SignatureMonth Day W g&� a EPA Form 8700-22(Rev. -05) Previous editions are obsolete. DESIGNATED FACIL TO DESTINATION STATE(IF Rl//E'CUIRED) 8700-22 12v3 C8293378 541067895 041011577 M PD010918 SDO10918