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Please print or type. Form Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3.Emergency Response Phone4.Manifest TrackiNumber WASTE MANIFEST CAL000429774 1 (877) 577-2669 013401675 F L E 5.Generators Name and Mailing Add r s ilil e r- Generators Site Address(if different than mailing address) s (�mazon.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 U.S.EPA ID Number ` 17 Designated Facility Name and SiteAddress Eisf Century LMN, U.S.EPA ID Number 2095 Newlands Dr. East Fernley, NV 89408 Facility's Phone: 7755752760 NVD980895338 ga 91b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total 12.Unit 13.Waste Codes HM and Packing Group(if any)) No. Type Quantity Wl.Nol. X 1UN1950, Waste Aerosols, [flammable, (each not 1 CF 00024 P 331 D0011 exceeding 1 L capacity)] 2. 1, ERG#126 z 2. w c� 3. f I 4. I r 14.Special Handling Instructions and Additional Information am ma e Aerosols) 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, 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 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)(if I am a small quantity generator)is true. Generators/Offerors Printed/Typed Name Signature Month Day Year ..�Iex Ore,114,c 1 061 131201') 16.International Shipments F ❑Import to U.S. ❑Export from U.S. Port of entry/exit: ? Transporter signature(for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials LU � Transporter 1 Printed/Typed Name Signature Month Day Year O o- Isidro Martinez I OF,1 131212119 ZTransporter 2 Printed/Typed Na ure Montq, Day Year JV11 1 18.Discr pancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residuej j ❑Partial Rejection Full Rejection Manifest Reference Number. 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U ra Facility's Phone: W - 11 18c.Signature of Alternate Facility(or Generator) Month Day Year a z h19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 2. 3. 4. 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manife�l except as,noted in�lt8m 18a Printedllyped Name Sign tur r' i Month Day Year s - ' EPA Form 8700-22(Rev.12-17) Previous editions re obsolete. UESIGf\A E17 FACILITY TO EPA's e ft7 iJiFGST SYST fy)