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Please print or type. Form Approved.OMB No.2050-0039 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest TrackingNumber WASTE MANIFEST UNIFORM HAZARDOUS CAL000426099 1 18775772669 1000306975 DAT 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 2 Limited Parkway 4950 Pacific Avenue Generator's Phone: Columbus, CO 43230 Stockton, CA 95207 6.Transporter 1 Company Name U.S.EPA ID Number Stericycle Specialty Waste Solutions Inc IMNSOOOI10924 7.Transporter 2 Company Name /J U.S.EPA ID Number ?E r 8.Designated Facility Name and Site Address St Lenvury tMN, 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 HM and Packing Group(if any)) No. Type Quantity Wt.Nol. 13.Waste Codes N1993, Waste Flammable liquids, n. o. s. (Ethyl 1 DM 00070 P 331 D@01 IJ002 lcohol, Acetone), 3, PG II, ERG#128 LU 2. W C9 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,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 NameSignaturRCL on a l f f L 1 Month Day Year 03 103 020 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.: W 17.Transporter Acknowledgment of Receipt of Materials LU Transporter 1 Printed/Typed Name Signature 7 e00001 Month Day Year Do Jared Marciel 103 103 020 Z I Transporter 2 Printed/Typed Name Month Day Year 18.Discrepancy 100, 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U 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) LLI G 1 i� 2. g/ ) 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 Signature MonthDay Year -fid' EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EF A's e-MANIFEST SYSTEM