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I F01tl11 1 Mf'�III'IIIII Form Approved.OMB No.2050-0039 <br /> Please print or type. <br /> UNIFORM HAZARDOUS <br /> t.Generator ID Numbor 1 Paye 1 cf Emergoncy Response P!xme d.Manifa t Trscking Number F L E <br /> WASTE MANIFEST CAL000429774 1 (8771 577-0669 <br /> S.GoneratorsName andMaiingAddressRttn:Site Safety Manager <br /> Generators Si!e Address(if different than mailing aadresc) <br /> Amazon.com Services, Inc. (DCK1) Amazon.com Services. Inc. (DCf,1) <br /> (209) 205-0080 2403 West Louise Avenue 22403 West Louise Avenue <br /> Gersrato s Phone: Manteca CA 95337 Manteca CA 95337 <br /> U.S.EPA ID Number <br /> 6,T 2nsporter t Company Na-e <br /> ialt Waste Solutions Inc MNS000110924 <br /> U.S.EPA ID Number <br /> C A IOLV 176(422. <br /> V V 11 W �L.r f'�✓4�V � !a..."'V•� U.S EPA10Numinrr <br /> s Designated Fay ,>i- _� s.te Address Y u m a Yes, LLC <br /> 2730 E. 13th Street <br /> Yuma AZ 85365 <br /> AZR000515924 <br /> S6 U.S.DOT Ce:7pGon(mdWrg Proper Shl�:nd Nar7e.Hazard Class,ID Number, W.Containers 11.TotaEP1 ste Cedes <br /> r a-=:Fc:%.r• G^up(if any)) No. Type Quantit <br /> H..f <br /> Non-RCRA Hazardous Waste. Liquid (Latex Paint, 1 DF 0018 -- - <br /> Soap) , I <br /> w 1 <br /> z <br /> i <br /> LU - - *----- 1 - - <br /> 4. <br /> 14,SpeaalHandling Ins 6kbonsand Additional Information 1. 109763(LoosePack Non-Regulated Waste) <br /> U1d�sy�3�151 <br /> 5. GEN ERATOR'SIOFFEROR'S CERTIFICATION: I hereby declare that the consents of thds tmteignment a e fully and accurately described above by the proper shipping name,and are classified,packaged, <br /> r asv.Ed a^d a e a a-'d•and are n al respells in pry cerdax tr t'an,=,a '9 to applicable inlernationaland national governmental regu'ations.rc export shipment and I am the Primary <br /> E xper e,l ce rty-a!:e.� ^ns of this cons gnr eni ccn`_rtr 1�t?x to s cl�e aZac�cd cPA P::rr x edgment cf Consent <br /> I corvly that the waste rr!v,,trza:�<tPn�r,e-s�a..red�40 CFR 2E2.27,a1; l am a W;e Y-a-'t7 ea a a'crl o!b:Iif I mal quanCb generator is true. <br /> S _ o !.forth Day Yow <br /> Generatr s Offc er5 PdnlediTyped Nam t <br /> J 16,Inlernalional ShipmentsPort of enl lexie <br /> ❑Iport to <br /> .mExport from U.S. ry <br /> i- Date leaving U.S: <br /> ? Transporter signature(tor exports only): <br /> 17.Tres i es er h k wvlxdgn enl of Receipt of Materials <br /> Transporter 1 PrinW.11yped Name S n Alonth Day Yea <br /> o Isidro a r' r <br /> gnatu. Month Day Year <br /> Z T(anspori�2 P ntedfTyped Na /0 <br /> ¢ t,J` Y L <br /> 18 Discrepancy <br /> 18a Dismoancy Indication Space Quantity Type El Residue Partial Rejection Full Rejection <br /> tivni(esl Reference Number: <br /> U.S.EPA'D Namb r <br /> t 6b Alternate Facility(or Generator) <br /> J <br /> V <br /> Facil:Hs Phone: Month Day Year <br /> L 18c.Signature of Alternate Faolity(or Generator) <br /> H <br /> z <br /> 19.Hazardous lVasle Repoli Management Method Ccdos(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> 0 2. 3. 4. <br /> 20.D signated Facility Cnvner or Cperalor:Cert kab A of receipt of hazardous materials covered by the manifest except as noted in I•em 180 Mon!h Day Year <br /> 'TImed'typed Name Signature 1 lj, <br /> EPA Form 6700.22(Rev.12-17) Previous editions are obsolete. )LSiGk . .D Fit,Cit-ITY TO EPA's e-MiANIF1 SYSTE( <br /> ayrrra_��o �•�,.� roo-zcraoi. rr..rnn..��n .-.....-.-.-...-.. .. -- • -• - • - -- - • - - <br />