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-= IIIIIII�IIM111 <br /> 'P'leas'e PW or type (Form des' ned for use on elite(12-pitch)typtrrnler-) Farm Approved OMB Na.245()d1U39 <br /> IINIFORM HAZARDOUS 1.Generator ID Humber 2.Paps t of 3 Emergency Response Ptrara a Illandest TMkM9 fllrmber <br /> mmFm I CA1.080426099 1 8775772669 011386913 F L E <br /> 5 GeneraEors Naahe and kWa 9 Add— GpiCat S Site Address(d dh w3 t than mmHg address) <br /> Victoria's Secret 1144 Victoria's Secret*1144 <br /> 2094761963 4950 Pacific Avenue, Space 425 49% pacific Avenue <br /> Gwwatoes Phone Stockton, CA 95287 Stockton, CA 95207 <br /> ranspaltY 1CorrWyNaffm <br /> US EPA ID Number <br /> Stericycle Specialty Waste Solutions Inc HNS000110924 <br /> 7 Transporhar 2 Company Name US EPA ID Nufrd" <br /> 8 F U <br /> Yuma Yes, LLC <br /> 2730 E. 13th Street <br /> Faa1' 's phnne s1� 4 t-0.�aaMuat <br /> wpZ V--'si W Yurw" ne,ha <br /> AZ 95365 ,t +�+ °s 13` <br /> 9b U.S u�ro..�apQ y s <br /> +.ry%iwS iHizard Clens.ID MnW. 10 Cuntamr5 11 ca <br /> 9a 13 Waste Codes <br /> HM and Padang G—P Gf any)) No Type qty MAkr. <br /> 1 <br /> o Non RCRA hazardous waste, liquid (Soaps, 1 CF 00008 P 3 <br /> r P <br /> Lotions) <br /> LLP <br /> x 2 <br /> LU <br /> CD T- <br /> I $ <br /> 3 h <br /> r <br /> 4 r } <br /> i f <br /> 14 SWJA HoWing Irstmctih>.iS and,ldddit DFW Inlarrtrdbon <br /> ,.fir ter - 1. 110902(State Regulated Liquids) <br /> 15. C-&4 A70R'SKWFE1R0R S CEKI14CATlW 1 hereby dad=dho the coniierrts of this cals9welem are idly and wwrA*dcsabod abo're by the Paler 5hpwn9 name,aIa arc das0ed,pew, <br /> marked and W)eledk9ataxlW,and are in all resperl5 n proper condition fur trartPart arxe drag b appkabta international and naf wl 9W=ffWntW regiAnns 9 export S*IK-M and I an the PnnLAY <br /> Exporter,l ce*that the con0"of this[nnsWmN1 cooloftn 10 the tems of the alrached EPAAcbm7&l Wimt of Cansant <br /> I oertihr hat the xasto MWnt WOn%at enhent idenld'hed In i0 CFR 262 27(a)(i I am a large Quenbty 9esheAor)or(b)91 am a$Alai Quantity generator)is hue <br /> Yped Nwe <br /> � K�(call SRCL rep on behalf of Liaite <br /> 16, L n invW b U S R Export Bran U S P0A d alwem <br /> T -wre on Oats leaoi U S.. <br /> a 1T <br /> wmom Day <br /> � TranspCgler 1 PrirhtedfTypad Name -. <br /> a <br /> Krjyptopher Almanza 021 07120111 <br /> T 2 PtiW"TVW Name ear <br /> 10-711 IF <br /> to a�h�sr 1 ll ( 11 t <br /> 18a 019mpancy Indcabon Space Ll Quaroy C.JType C_.1 f�esidhe l_J Paral tiR"e'non L_..1 R41 F*,-flan <br /> Manifest RoWmce W nber <br /> 1 A�rrr11B Faaltty(a Generathr) <br /> US EPA I0 t=ber <br /> v <br /> Fai 't Phone. <br /> W 18c SgnaUm of Allanhela FaaRy(Of Generates) Moth Day Year <br /> 19 Haeardons tVaW Report Management M UIhod C+des(i e,codes br hazardous hrdsla trealrneM,doost and rmwkq systems) <br /> C1 q 1 ` rr `, 2 3 A <br /> "4 , <br /> 20 Designated Fadtiy i7ATw arOperator Ceroic3tion of receipt d hazmftZ m8rertele mMerad by Inn m fik V except as noted m Item 1 Ba <br /> Yped NamS4aur<e Month 00y year <br /> %'-Ova- 1 1 <br /> EPA Farm a700-Z2(Rev.346) previous edtions are obsolete. DFSIGNAT(D TACILTTY TO DESTINATION STATE(IF R£QUIM D) <br />