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Form Approved.OMB No.2050-0039 <br /> Please print or type. 2.Page 1 of 3.Emergency Response Phone 4.Manifest Tracking Number <br /> 1.Generator ID Number 1 877-577-2669 013401707FLE <br /> UNIFORM HAZARDOUS CAR000298380 <br /> WASTE MANIFEST Generators Site Address(if different than mailing address) <br /> 5.Generators Name and Mailing Address 2403 WEST LOUISE AVE <br /> AMAZON.COM SERVICES,LLC DCK1 MANTECA CA,95337 <br /> P.O BOX 80842 <br /> SEATTLE WA,98108 <br /> U.S.EPA ID Number <br /> Generators Phone: 206-4131152 MNS000110924 <br /> 6.Transporter 1 ompany ame <br /> Stericycle Specialty Waste Solutions Inc U.S.EPA ID Number <br /> MNS000110924 <br /> 7.Transporter 2 Company Name <br /> Stericycle Specialty Waste Solutions Inc U.S.EPA ID Number <br /> dress CAD008364432 <br /> 8.Designated Facility Name and Site Ad <br /> Rho Chem LLC <br /> 425 Isis Ave. <br /> Inglewood CA,90301 i <br /> Facility s Phone: 32 -776- 233 <br /> 10.Containers 11.Total 12.Unit 13.Waste Codes <br /> 9a. <br /> 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, No Type Quantity Wt.N01. <br /> HM and Packing Group(if any)) D002 <br /> 7-RQ,UN3267,Waste Corrosive liquid,basic,organic,n.o.s.(Sodium Hydroxide, 1 DF 123 P <br /> W Potassium Hydroxide), 8,PG ll,(D002),ERG#153 122 <br /> O <br /> Z 2. <br /> W <br /> L9 <br /> 3. <br /> 4. <br /> 14.Sppecial Handling Instructions and Additional Information <br /> 1)109732(Basrc/Corrosive/ Organic Loosepack);Line 1: <br /> respe in roper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary <br /> 15. GENERATOR'SIOFFEROR'SCERTIFICATION: Thereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,package <br /> marked and labeled/placarded,and ares all p P <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment(b Consent. on ay ear <br /> I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator) <br /> Lure or(b)(if I am a small quantity generator)is true. 06 20 2019 <br /> enerator's ero s nnted yped ame ROMMEL DINGLE <br /> ROMMEL DINGLE <br /> ❑Export from U.S. Port of entrylexit: <br /> -1 16.International Shipments Import to U.S Date leavin U.S: <br /> F- <br /> Z Transporter si nature for exports onl on ay ear <br /> W 17.Transporter Acknowledgment of Receipt of Materials rgna ure 06 20 2019 <br /> Transporter 1 Printed/Typed Name Isidro Martinez <br /> on ay ear <br /> O Isidro Martinez 2019 <br /> ignature <br /> a 06 20 <br /> QTransporter 2 PrintedrTyped Name Andy Varela <br /> Andy Varela <br /> t- <br /> 18.Discrepancy 13 Residue Partial Rejection Full Rejection <br /> rl_ype <br /> 18a.Discrepancy Indication Space n Quantity 1IJJ�� <br /> Manifest Reference Number: U.S.EPA ID Number <br /> 18b.Allemate Facility(or Generator) <br /> J Month Day Year <br /> U <br /> I Facili s Phone: <br /> W 18c.Signature of Alternate Facility(or Generator) <br /> Q <br /> Z <br /> N 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 4 <br /> 3. <br /> 2. <br /> LIJ 1. <br /> H141 <br /> Month Day Year <br /> 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the rnSignaturecept as noted in Item 1 a 07 09 2019 <br /> PrintedlTyped Name Gina Webb <br /> Gina Webb DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br /> EPA Form 8700-22(Rev. 12-17) Previous editions are obsolete. <br />