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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number <br /> WASTE MANIFEST CAR000298380 1 877-577-2669 013120138FLE <br /> 5.Generator's Name and Mailing Address Generator's Site Address(if different than mailing address) <br /> AMAZON.COM SERVICES,LLC DCK1 2403 WEST LOUISE AVE <br /> P.O BOX 80842 MANTECA CA,95337 <br /> SEATTLE WA,98108 <br /> Generators Phone: 206-413-4526 <br /> 6.Transporter 1 company ame 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 and Packing Group(d any)) 13.Waste Codes <br /> No. Type Quantity Wt.Nol. <br /> 1.NON-RCRA HAZARDOUS WASTE,LIQUID(LATEX PAINT,SOAP), <br /> OF 3 DF 503 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 /> 541638;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 /> 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. <br /> enerato s eros Printed7ryped Name Signature Monthay ear <br /> Shara Davis Shara Davis <br /> 08 1 07 1 2019 <br /> 16.International Shipments <br /> F Import to U.S ❑Export from U.S. Port of entry/exit: <br /> z <br /> Transporter signature for exports only): Date leaving U.S.: <br /> w 17.TransporterAcknowledgment of Receipt of Materials <br /> � <br /> Transporter 1 Printecirryped Name Signature on ar <br /> Day e <br /> a ISIDRO MARTINEZ ISIDRO MARTINEZ 08 07 2019 <br /> QTransporter Printed/Typed Name Signature Month Day Year <br /> TROY MADERE TROY MADERE 08 14 2019 <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 /> J <br /> U <br /> LL Facility's Phone: <br /> C3 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 /> C 1. 2. 3. 4. <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 /> Pdntedrryped Name Signature Month Day Year <br /> PATRICIA ALVAREZ PATRICIA ALVAREZ 08 20 2019 <br /> EPA Form 8700-22(Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />