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From:SMC Inc. Fax:(855)444-7624 To: Fax: (916)323-3500 Page 2 of 2 68;0812018 1011 PFA, <br /> State of California—Califomia Environmental Protection Agency Department of Toxic Substances Control -HWMP <br /> P.O.Box 606,Sacramento,CA 95812-0806 <br /> PERMANENT STATE ID NUMBER APPLICATION <br /> Please type or neatly print in ink. Please review the line-by-line instructions carefully. <br /> To check on the status of your request,go to hqp:1/www.hwts.dtsc.ca.qov and click on Reports. <br /> NEW NUMBER REQUESTS Check all that apply. (See instructions.) <br /> i <br /> ❑ 1. 1 am applying for a new permanent California ID number as a hazardous waste: ❑ Generator ❑Transporter <br /> Reason for new number: A. ❑ Never had a number B. ❑ Business moved C. ❑ Legal owner of business changed <br /> If your business generates greater than 100 kg of RCRA hazardous waste other than those hazardous waste listed in 40 CFR 261.5 <br /> subparts(c)and(d),per month, complete Form 8700-12 for an EPA (federal)1D number. <br /> CHANGES TO STATUS OR INFORMATION FOR AN EXISTING STATE ID NUMBER (See instructions.) <br /> For existing ID number: CA L 0 0 0 3 4 8 8 2 4 <br /> ❑ 2. 1 am updating the mailing address and/or contact information only. <br /> ❑ 3. 1 am inactivating this ID Number. <br /> M 4. 1 am reactivating this ID Number. Reason (please select one): A. ❑ Verification Questionnaire B. IN Other <br /> ❑ 5. 1 am changing the business name only,no ownership change. <br /> (See instructions.) <br /> 6. Site/Facility/Business Name(Include DBA): Silvestre's Mechanical Company,Inc. <br /> 7. Site Location: 6030 E.Kettleman Lane <br /> Street <br /> Lodi CA 95240 San Joaquin <br /> City State Zip County <br /> 8. (a)Federal Employer ID Number (b)Board of Equalization Fee Account Number N/A <br /> ((b)is only required from generators of greater than 5 tons per calendar year.) <br /> 9. Mailing Address. <br /> PO Box 2507 (See instructions.) <br /> Street <br /> Lodi CA 95241 <br /> City State Zip <br /> (See instructions.) <br /> 10. Site Contact Person: Carlos Hernandez <br /> First Name Last Name <br /> Contact Person Address: PO Box 2507 <br /> Street <br /> Lodi CA 95241 <br /> City State Zip <br /> Contact Person Phone Number: ( 209 ) 333-2608 Fax Number: ( 855 ) 444-7624 <br /> Area Code Phone Number Area Code Fax Number <br /> Contact Person Business Email Address: carlos@smci209.com Preferred Primary Communication: ❑ Mail w Email <br /> (See instructions.) <br /> 11. Legal Business Owner(not property owner): Silvestro s Mechanical Company, Inc. <br /> Name <br /> Owner Address: PO Box 2507 Lodi CA 95241 <br /> Street City855 StaZip <br /> Owner Phone Number: ( 209 ) 327-0749 Fax Number: �) 444-7624 <br /> Area Code Phone Number Area Code Fax Number <br /> 12. Standard Industrial Classification(SIC)Code for the Site: 3 5 8 5 (4-Digit Number) (See instructions.) <br /> 13. Certification: I certify under penalty of law that the information on this document was prepared to the best of my knowledge and <br /> belief to be, true, accurate and complete. <br /> SIGNATURE DATE 08/08/2018 <br /> NAME(print) Carlos Hernandez TITLE Secretary PHONE 209-333-2608 <br /> DTSC Form 1358(01117) <br />