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Pleaseprint or rype, Form Approved.OMB No.20500039 <br /> UNIFORM HAZARDOUS 1 Gcurerahx ID Nrbe <br /> rurr 2.Page i of 3. Res Phare 4.Manifest Trac n9 Ilurnber <br /> WASTE MANIFEST CALOOM9774 1 (8 577-2669 014010739 FSE <br /> 5.Generator's Name and Mailing Address metGenerabi s Site Address(if&fererd fan mailing address) <br /> Amazon.con Services, Inc. (DCK1) Amazon.com Services, Inc. (DCK1) <br /> (209) 205-0080 2403 West Louise Avenue 2403 West Louise Avenue <br /> Generators Phone: Manteca, CA 95337 Manteca, CA 95337 <br /> 6.Transporter t Company Name U.S.EPA ID Number <br /> Stericycle Specialty Waste Solutions Inc IMNSOOOII0924 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> Worldwide Recovery Systems 1 ICAR000175422 <br /> a.Designated Fad4ly Name and Sae Address Yuma Yes, LLC U.S.EPA ID Number <br /> 2730 E. 13th Strut <br /> Yuma, AZ 85355 <br /> Facukys Pnone:9286428938 AZ R000515924, <br /> ga. 9b,U.S.DOT Description(hdudinp Proper Stopping Name,Hazard Class,to Number, 10.Containers 11.Total 12.LhI 13.Waste Codes <br /> HM Packeg Cep(d az7)) No. Type Qua ity Wuvol, <br /> Non—RCRA Hazardous Waste, Liquid (Latex Paint, 2 DF 00393 P 331 <br /> o Soap), <br /> LU <br /> z z. <br /> 3. <br /> 4. <br /> 1a.Special H wai°rs'ndAddiWral'rd°rnnn°" 1. 109763(LoosePack Non-Regulated Waste) <br /> 15. GENERATOR'&OFFERORS CERTIFICATION:!hereby decant that lha cmim*of ft eonslQrvrwnt aro tuuy and acarratey described above by the proper shipping name,and are ctuified,packaged, <br /> marked and aetledlplacwdad,and are in at respects In proper mrd tbn for traroport a000rQrp b appiubie intemavonalard national governmental regud0orrs.tf export sNpmant erd tam to Prrnary <br /> Expo ler,I oar*thel ere cements of fiscona0wrentmikern b the WM of theaached EPAAcknowfeagn"of Corned: <br /> 1 oart)fy fA Ow wade mkirr®Fion statement id:nt W In 40 CFR 29.227(x)f4I am a Iarge wairtN genefa«1 or(b)(III am a smell quantity ganeraw)is true. <br /> GerrararofslOtierofs � Stnalure Mona Oay ear <br /> 16. ❑U„p«1 to u s. ❑EVW from U.S. Pat or entiyro <br /> z Transporter 80uh-(ter exorfx onty): Data Inv"U.S.: <br /> 17,Transporter AdmW4d7rwnt of Remo of Materials <br /> Transporter 1 Printodaygwd Name j SI nen Monty Day Year <br /> a Isidro Martinez <br /> TrxrttporW 2 Prttled iyped NameSOW- Month Day Year <br /> 1B awepandy <br /> 18a.Discr4kv-cy.Indication Space 11 Quantity ❑Type ❑Residue ❑Partial RejeW. ❑Fug Rejection <br /> �L <br /> MWesl Reference Number: <br /> 18b.Alfert47fe Pearcy(or Gtaterabr) U.S.EPA ID Number <br /> U <br /> U.; Faedty's Pham: <br /> 18o Signature of Alternate Fau7ity(a Generabr) Monty Day Year <br /> Q <br /> 19.Hazardous Waste Report Management Method Codes(ie..codes for hazardous wears tualment,disposal,and racycrng systems) <br /> LU 1• 2 3. 4. <br /> 20.Designatod Facility Owner or Operator Cart faafion of receipt of hazardous covered by dw manifest except as ncW in Item 18a <br /> A Month Day Year <br /> hThAu- 0 1 <br /> AUrANLk— <br /> EPA Form 8700-22(Rev.12-17) Previous edtions are obsolete. 0tSIGNJTQ0 FACILITY TO EPA's e-MANIFEST SYSTEM <br />