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i Please print or type. 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 GAL000426099 1 18775772669 013123981 FLE 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 Generator's Phone: Stockton, CA 95207 Stockton, CA 95207 6.Transporter 1 Company Name U.S.EPA ID Number Stericycle Specialty Waste Solutions Inc IMNS606110924 7.Transporter 2 Company Name _ /t /� /�! �/ /t` ..._,� �^- U.S.EPA ID Number /1,/! ..�L®� /� -'-�0 /"&# elor, 'P 8.Designated Facility Name and Site Address 5 Century EMN, LLC / U.S.EPA ID Number 2095 Newlands Dr. East Fernley, NV 89408 Facility's Phone. 97927r IQ 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.Nol, 0 1993, Waste Flammable liquids, n. o. s. (Ethyl 1 DM 00131 P 331 D001 002 lcohol, Acetone), 3, PG II, ERG#128 z 2. LU 3. 4. 14.Special Handling Instructions and Additional Information 1. 110905(F 1 am ma b 1 e Liquids) 15. GENERATOR'SIOFFEROR'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. Generator's/Offeror's Printed/Typed Name Signatur p 0 Rhalf f Limite Month Day Year III 1 11 019 16.International Shipments F- ❑Import to U.S. ❑Export from U.S. Port of entry/exit: ? Transporter signature(for exports only): Date leaving U.S.: 17.Transporter Acknowledgment of Receipt of Materials Transporter 1 Printed/Typed Name Signature Month Day Year a Jared Marciel li 1 11 019 Z Transporter 2 PrintedlTyped Name ✓ Sigq&wel Month Day Year F 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number C) L Facility's Phone: w 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) C3 1. � y /C�/ 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 f Signature Month Day Year DESIGNATED FACILITY TO EPA's e•MANIFEST SYSTEM EPA Form 8700-22(Rev.12-17) Previous editions are obsolete.