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2050-0039 <br /> 'lease <br /> 'lease print or type. Form Approved.OMB No.20 <br /> UNIFORM HAZARDOUS 1 �' �ID Number 2.Page 10l 3.Errer7) Response Phone X0131Number <br /> Or�O F L E <br /> WASTE MANIFEST CAL000429774 1 f 877) 577-2669 <br /> 5.Generatoes Name and WiluV Address Geoerator's Silo Address(if different than mailing address) <br /> Amazon.com Services, Inc. (DCKD Amazon.com Services, Inc. (DCK1) <br /> (209) 205-0080 2403 West Louise Avenue 2403 West Louise Avenue <br /> Generator's Phone: Mantecal CA 95337 Manteca, CA 9533Z <br /> B.Transporter 1 Company Name U.S.EPA ID Number <br /> 7.Transporter 2 Company Name U.S.EPA ID Number <br /> S <br /> 8.Deslgnated FadlityName and Sita Address Yuma Yes, LLC U.S.FPA ID Number <br /> 2730 E. 13th Street <br /> Yuma, AZ 85365 <br /> Facility's Phone: <br /> ga 9b.U.S.DOT Description(tnduding Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes <br /> HM and Paddng Group(if any)) No. Type Quantity WL/Vol. <br /> Edon-RCRA Hazardous Waste, Liquid (Latex Paint, 2 DF 00440 P 331 <br /> Soap), <br /> 0 <br /> 3. <br /> 4. <br /> 14.Special Hand6nginstructions and Additional lnformation 1. 109763(LoosePack Non-Regulated Waste) <br /> [Generatoes/Offeror's <br /> GENERATOR'SIOFFEROR'8 CERTIFICATION: I hereby declare that the contents of this consignment aro fully and accurately desalted above by the proper shipping name,and are dassMed,packaged, <br /> marked and labeled/placarded,and are in all respects N proper condition for transport according to appllmhle Wematlordand national governmental regrdatlons.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 EPAAdknowledgment of Consent <br /> I certify that the waste min6Nzation statement Identiffed In 40 CFR 26227(a)(d I am a large quantity generator)or(b)(HI am a small quantity generator)Is true. <br /> PrintedfTyped Name Signature Month Day Year <br /> l of-d-la,lo C>-0 t6i1 C ihs 05 1py,19 <br /> International Shipments ❑Import to U.S. ❑Exportfrom U.S. Paofwytaxit <br /> 2[16. <br /> Transporter signature(for exports only): Date leaving U.S.: <br /> X 17.TransporterAdatowledgmerd of Receipt of Materials <br /> LLJTransporter 1 Printed/Typed Name signature Month Day Year <br /> O <br /> n. <br /> tinP7 1719 05 121Z 1 <br /> U) Trans 2 Printed/Typed N �f /�J Sdgna Mon ay Year <br /> 1018.Dlsaepancy <br /> I Ba.Disaepanky Indication Space ❑ Quantity [:]Type ❑Residue ❑Partial Rejectlon ❑Full Rejection <br /> Manifest Reference Number. <br /> 18b.Alternate Facility(or Generator) US.EPA ID Number <br /> U <br /> ra+. Fadiity's Phone: Month pay Year <br /> w 18c.Signature of Alternate Facility(or Generator) <br /> 19.Hazardous Waste Report Managament Method Codes(Le.,codes for hazardous waste treatment,disposal,and recydhhg Systems) <br /> p 1 2. <br /> �;q I I <br /> 20.Des naiad Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted In Item 18a <br /> y Na a Signatu Y <br /> I — — IRC I <br /> EPA Form 8700 (Ray.12- revious e <br /> ) PdiHbns are obso e . DESIG ATED FACIL10 TO EPA's e•MANIFE. SYSTEM <br />