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Please print or type. Fonn Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number 7a, f 3.Emergency Response Phone 4.Manifest Tracking Number <br /> WASTE MANIFEST CAR000298380 877-577-2669 014010689FLE <br /> 5.Generator's Name and Mailing Address Generators Site Address(if different than mailing address) <br /> AMAZON.COM SERVICES,LLC DCK1 2403 WEST LOUISE AVE <br /> P.0 BOX 80842 MANTECA CA,95337 <br /> SEATTLE WA,98108 <br /> Generator's Phone: --- 2064134526 <br /> 6.Transporter 1 CompanyTame U.S.EPA ID Number <br /> STERICYCLE SPECIALTY WASTE SOLUTIONS INC MNS000110924 <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> WORLDWIDE RECOVERY SYSTEM INC CAR000175422 <br /> 8.Designated Facility Name and Site Address U.S.EPA ID Number <br /> YUMA YES WASTE TRANSFER FACILITY <br /> 2730 E 13TH ST AZR000515924 <br /> YUMA AZ,85365-1901 <br /> Facility's Phone: 623-326-9640 <br /> 9a, 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11..Total 12.Unit <br /> HM <br /> and Packing Group(if any)) No. Type Quantity WtJVol. 13.Waste Codes <br /> 1.NON-RCRA HAZARDOUS WASTE,LIQUID(LATEX PAINT,SOAP), <br /> 0 2 DF 251 P <br /> 331 <br /> Z 2. <br /> W <br /> 3. <br /> 4. <br /> 14.Sppecial Handlingg Instructions and Additional Information <br /> 1.109763(LOOSEPACK NON-REGULATED WASTE) <br /> WO#Y19200;Line 1: <br /> 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, <br /> 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 <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. <br /> 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. <br /> enerato s eros Printed/Typed ame Signature Month Day Year <br /> Alex Orellano Alex Orellano 12 05 2019 <br /> 16.International Shipments <br /> F— Import to U.S ❑Export from U.S. Port of entrylexiC <br /> Transporter signature for exports only): Dale leaving U.S.: <br /> Li 17.Transporter Acknowledgment of Receipt of Materials <br /> Transporter 1 Printed/Typed Name Signature Month Day Year <br /> MO ISIDRO MARTINEZ ISIDRO MARTINEZ 12 05 2019 <br /> rn <br /> Q Transporter 2 Printedlryped Name Signature month Day Year <br /> W PAUL D.MACFARLAND JR. PAUL D.MACFARLAND JR. 12 10 2019 <br /> F <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Space Quantity ❑type ❑Residue ❑Partial Rejection ❑Full Rejection <br /> Manifest Reference Number: <br /> 18b.Alternate Facility(or Generator) U.S.EPA ID Number <br /> V <br /> tQi Facili s Phone: <br /> W 18c.Signature of Alternate Facility(or Generator) Month Day Year <br /> Q <br /> Z <br /> N19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> G <br /> H141 <br /> 20.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a <br /> PrintedfTyped Name Signature Month Day Year <br /> PATRICIA ALVAREZ PATRICIA ALVAREZ 12 16 2019 <br /> EPA Form 8700-22(Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />