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7 I Please print or type.(Form designed for use on elite(12-pitch)typewriter.) Form 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 CAL000427614 1 8775772669 010788847 F L E 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) Bath & Body Works 65 Bath 8 Body Works#65 2099524396 5308 PACIFIC AVE, SHERWOOD MALL/ SPACE 6 5308 PACIFIC AVE Generators Phone: STOCKTON CA 95207 STOCKTON, 6.Transporter 1 Company Name U.S.EPA ID Number rix cle Specialty Waste Solutions Inc MNS000110924 7.Transporter 2 mpany Name U.S.EPA ID Number 8.Designated acilityNameand iteAddress `1st Century EMN, LLG U.S.EPAIDNum er 2095 Newlands Dr . East Fernley, NV 89408 Facility's Phone: 775575760 NVD980895338 ga 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./Vol. X1- UN1993, Waste Flammable liquids, n. o. s. (Ethyl 1 CF 00016 P 331 D001 U00" Alcohol, Acetone), 37 PG II, ERG#128 - ------ - -- Z X2. UN1950, Waste Aerosols, [flammable, (each not 1 GF 00002 P 33 D003 0 exceeding 1 L capacity)] 2. 1, ERG#126 -- 3. i 4. i 14.Special Handling Instructions and Additional Information 1. 110905(Flammable Liquids) 2. 110904(Aerosols, Flammable) ' 15. GENERATOR'S/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.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. Generators/Offerors Printed/Typ d Name Signature WtL r eo n behalf of L i m i t e Month ay ear 1' od 201 i 16.International Shi ments Import to U.S. ❑Export from U.S. 4 of entry/exit: Z Transporter signature for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials UJ Transporter 1 Printed/Typed Name ISignature ! Month Day Year a Johnny Har `/ 1 0r� 201 Z Transporter 2 Printed a • Signalur t Month Day Year 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity El Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U Q Facility's Phone: w 18x.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) � 1. 2. 3. 4, W L�� 1 20.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed/Typed Namex Signature Month Day Year M�c 1k ,1 EPA Form 8700-22(Rev.3-M) Previous bd3ons are obsolete. DESIGNATE AC TY TO DESTINATION STATE(IF REOUIRED) 8700-22. 12v3 08293378 541067816 040976657 M PD120817 SD120817