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Pledse print or type.(Form designed for use on elite12- itch typewriter.)( 2-pitch)tYP ) 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 010788849 F L E 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) Bath & Body Works 1510 Bath & Body Works#1510 094729339 4950 PACIFIC AVE, WEBERSTDWN MALL/ SPACE 4950 PACIFIC AVE Generators Phone: STOCKTON CA 95207 STDCKTDN CA 95207 6.Transporter 1 Company Name U.S.EPA ID Number Steric cle Specialty Waste Solutions Inc MNS000110924 7.Transporter 2 Co y me U.S.EPA ID Number S -�e3�Z 8.Designated ;, ,;tyN!a20ad.1it 46,�es 2 Century EMN, LLC U.S.EPA ID Number 2095 Newlands Dr. East Fernley, NV 89408 Facility's Phone: 7755752760 NVD980895338 ga_ 91b.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.Nol. X1- UN1950, Waste Aerosols, [flammable, (each not 1 CF 00002 P 331 D001 o exceeding 1 L capacity)] 2. 1, ERG#126 w LU X 2. UN1993, Waste Flammable liquids, n. o. s. (Ethyl 1 DM 00062 P 33$ D001 U00 Alcohol, Acetone), 3, PG II, ERG#128 3. i 4. 14.Special Handling Instructions and Additional Information 1. 110904(Aerosols, Flammable) 2. 110905(F l a m e a b l e Liquids) 15. GENERATOK&OFFEROR'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.dexport 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 true. Generator's/Offeroes Printed/Typed Name 61gnature CL r e o n b e h a l f o f L i A 1 t e Monthay ear 16.(national Shi ents 1 I 2017 ZImport to U.S. ❑Export from U.S. ort of entry/exit: Transporter sinature for exports onl : Date leaving U.S.: IX w 17.Transporter Acknowledgment ofReceiptofMaterials Transporter 1 Printed/Typed Name S "nature iMonth ay ear a Johnny Har eren 11 1 1 0d 201 Transporter 2 Printed/Typ Signatu on Day Year 18.Discrepancy 18a.Discrepancy Indication Space Quantity El Type Ll Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 181b.Alternate Facility(or Generator) U.S.EPA ID Number J_ rJ Q aL Facility's Phone: w 18c.Signature of Alternate Facility(or Generator) Month Day Year Q Z y19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) In 1. Z 3. 4. 20.Designated Facili Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Pnnted/Typed Name SignatureMonth Day Year EPA Form 700-22(Rev.3-05) Previous editions are obsolete. DESIGNATED F IJ TO DESTINATION STATE(IF Ei1UIRED) 8700-22_12v3 C8293378 S410 95 040990812 M PD120817 SD120817