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Please print ort e. I yp Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1 �t l �►� 099 2.P�ge 1 of 3.Arnp[�pDGy jg g§Phone 4.Maniteest Tracck�ingNumber WASTE MANIFEST //,,��// bbbb 1 L�§a Gor F L E 5.Generators Name and Mailing AddrVictoria' s Secret 1144 Generator's SiteAddress(ifdfte6VW1il1ggagdreg�cret#1144 2094761963 4950 Pacific Avenue, Space 425 4950 Pacific Avenue Generator's 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 `1-a� Cro �75Z 8.Designated Facility Name and Site Address 21st Century EMN, LLC U.S.EPA ID Number 2095 Newlands Dr. East Fernley, NV 89408 Facility's Phone: 7755752760 NVD980895338 9a, 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 UN1993, Waste Flammable liquids, n. o. s. (Ethyl 1 DM 00026 P 33 D001 U002 Alcohol, Acetone), 3, PG II, ERG#128 - w z 2. w I 0 3. r r, 4. v y w i 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,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 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 Signature CJ C rep On beh �f ].10 j t Month Day Year " ' ,... _.. 041 04 201 J 16.Int rnational Shipments ❑Import to U.S. ❑Export from U.S. Port of entry/exit: z Transporter signature(for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials Lu Transporter 1 Printed/Typed Name Signature -` <- .^. . ,..... Month Day Year a Krista her Almanza1 041 04 201 M Transporter 2 Printed/Typed Name Signa e 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'- Facility's Phone: w 18c.Signature of Alternate Facility(or Generator) Month Day Year a z N19.Hazardous Waste Report Management Method Codes(i ,disposal,and recycling systems) .e.,codes for hazardous waste treatment LLJ � 1 � � 2. 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 Sign Month Day Year -- u cR EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM