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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 Phone 4.Manifest Tracking Number WASTE MANIFEST CAR000298380 1 877-577-2669 013401675FLE 5.Generators Name and Mailing Address Generator's Site Address(if different than mailing address) AMAZON.COM SERVICES,LLC DCK1 2403 WEST LOUISE AVE P.O BOX 80842 MANTECA CA,95337 SEATTLE WA,98108 Generators Phone: 206-413-4526 6.Transporter 1 Company ame U.S.EPA ID Number Stericycle Specialty Waste Solutions Inc MNS000110924 7.Transporter 2 Company Name U.S.EPA ID Number Stericycle Specialty Waste Solutions Inc MNS000110924 8.Designated Facility Name and Site Address U.S.EPA ID Number 21st Century Environmental Management of Nevada,LLC NVD980895338 2095 Newlands Drive East Fernley NV,89408 Facility's Phone: 775-575-2760 ga. 9b.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 Wt.N01. 1.UN1950,Waste Aerosols,[Flammable,(each not exceeding 1 L capacity)]2.1,ERG#126 D001 rY O 1 CF 24 P q 331 z 2. W 0 3. 4. 6-1 14.Sppecial Handling Instructions and Additional Information 1)109718(Flammable Aerosols);Line 1: 15. GENERATOR'S/OFFEROR'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 EPAAcknowledgment 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. enerato s eros PrintedfTyped Name Signature Month Day Year Alex Orellano Alex Orellano 06 1 13 2019 --r 16.International Shipments1:1 F— Import to U.S ❑Export from U.S. Port of entry/exit: Z Transporter signature for exports only): Date leaving U.S.: W 17.Transporter Acknowledgment of Receipt of Materials Transporter 1 Printed/Typed Name Signature Month Day Year 000 Isidro Martinez Isidro Martinez 06 13 2019 Z Transporter 2 Printed/Typed Name Signature month Day Year Q Dave Smothers Dave Smothers 06 13 2019 F- 18.Discrepancy 1Be.Discrepancy Indication Space ❑Quantity ❑type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number: 18b.Alternate Facility(or Generator) U.S.EPA ID Number J U LL Facilitys Phone: LO 18c.Signature of Alternate Facility(or Generator) Month Day Year Q Z h19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) H141 4. 20.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Printed/Typed Name Signature Month Day Year Devon Bailey Devon Bailey 07 02 2019 EPA Form 8700-22(Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM