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i Please print or type. Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number FPae1 of 3.Emergency Response Phone 4.Manifest Trackin Number WASTE MANIFEST CAL000426099 8775772669 012 53521 F L E 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) Victoria' s Secret 1144 Victoria' s Secret#1144 094761963 4950 Pacific Avenue, Space 425 4950 Pacific Avenue GeneratorPhone: Stockton, CA 95207 Stockton, CA 95207 's 6.Transporter 1 Company Name U.S.EPA ID Number Stericycle Specialty Waste Solutions Inc MNS000110924 7.Trans ort er 2 Company Nae U.S.EPA ID Number 8.Designated Facility Name and Site Address d I St Century EMN, U.S.EPA ID Number 2095 Newlands Dr. East Fernley, NV 89408 Facility's Phone7755752760 INVD980895338 9a. 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.Nol. X 1N1993, Waste Flammable liquids, n. o. s. (Ethyl 1 DM 00064 P 331 D001 U002 Alcohol, Acetone), 3, PG II, ERG#128 Z 2. LU 0 3. 4. 14.Special Handling Instructions and Additional Information 1. 110905(Flammable Liquids) 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,arca 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 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/Offeror's Printed/Typed Name SignatureSSRCL e p behalf of L i m i t e Month Day Year 05 01 019 J 16.International Shipments ❑Import to U.S. ❑Export from .S. Port of entry/exit: ? Transporter signature(for exports only): Date leaving U.S.: Lu 17.Transporter Acknowledgment of Receipt of Materials Transporter 1 Printed/Typed Name Signature Month Day Year y Jared Marciel 05 01 -019 Z Transporter 2 Printed/Typed Name r Month Day Year Laus c ~ II tq 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity 1:1 Type El Residue ❑Partial Rejection El Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U LL Facility's Phone: LJ 18c.Signature of Alternate Facility(or Generator) Month Day Year a Z N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 0 1. I 2. 3. 4. 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest sept as noted in Item 18a Printed/Typed Na a Si 8ture Month Day Year EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DE A ED A 11 ITY TO EPA's e-MANIFEST SYSTEM