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'lease print or type. Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS Generator ID Number 2.Page 1 of 3.Emergency Response one 4.Manifest Tracking Number WASTE MANIFEST L000429774 1 (877) 577-2669 013120137 F L E 5.Generators Name and Mailing Address Generator's Site Address(if different than mailing address) Amazon.com Services, Inc. (DCK1) Amazon. com Services, Inc. (DCK1) (209) 205-0080 2403 West Louise Avenue 2403 West Louise Avenue Generators Phone: Manteca, CA 95337 Manteca, CA 95337 6.Transporter 1 Company Name U.S.EPA ID Number Stericycle Specialty Waste Solutions Inc MNS000110924 7.Transporter 2 Company Name 7 t, U.S.EPA ID Number 8.Designated Facility Name and Site Address 21st Century EMN, LLC U.S.EPA ID Number 2095 Newlands Dr. East Fernley, NV 89408 Facility's Phone:775575276 N V D980895338 9a 9b.U.S.DOT Description(including Proper Shipping Name.Hazard Class,ID Number, 10.Containers 11.Total 12.Unit and Packing Group(if any)) No. Type ty Wt.IVol. 13.Waste Codes i HM Quanti -7—tJN1993, Waste Flammable liquids, n. o. s. 1 CF 00036 P 214 D001 o (Petroleum Distillates, Alcohol), 3, PG II, W ERG#128 LU RID, , Waste Toxic solids, organic, n. o. 1 CF 00003 P 331 DO05 006 s. (2, 4-1), Silver) , 6. 1, PG II, (D011), ERG# 154 D016 D027 ' 008 3. 4. i 14.Special Handling Instructions and Additional Information 1. 109741 (Waste Flammable Liquid) 2. 109796(Toxic L O o s e p ac k - Solids Only - No Fertilizers) 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,ard are classified,packaged, marked and labeledlplacarded,and are in all respects in proper condition for transport according to applicable international and national govemmental regulations.If export shipment and I am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached EPA Acknowledgment of Consent. I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b) #I am a small quantity generator)is We. Generato f0 eror's Printedrryped Name Signature Month Day Year /' \ 08 1 07 '019 _j16.International Shipments F_ ❑Import to U.S. ❑Export from U.S. Port of entrylexit: z Transporter signature(for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials LLJ Transporter 1 Printed/Typed Name Signature Month Day Year CL Isidro Martinez 08 07 -019 z Transporter 2 Pri tedrryped Name ► �- a ure Month Day Year 9 e 18.Discrepancy 18a.Discrepancy Indication Space ❑ quantity ❑Type ❑ResidueEl Partial Rejection ❑Full Rejection Manifest Reference Number: I> 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U ri Facility's Phone: UO 18c.Signature of Alternate Facility(or Generator) Month Day Year Q z 19.Hazardous Waste Repo(rttMMan)a�ge{ment Method Codes(i.e.,codes for hazardous)waste treatment,disposal,and recycling systems) LU 1 / 1 ! 1 2. I /T/ 3. 4. 20.Designated Facility Owner or Operator:Certification of receipt of harzzar-(d-ous materials covered by the manifest except as noted in Item 18a PrintedlTyped Name ��{� J _ Signature J MoDay Year � k lbw JVD J�vl Fy, I 1 EPA Form 8700-22(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e•MANIFEST SYSTEM