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State of California—California Environmental Protection Agency Department of Toxic Substances Control -HWMP P.O.Box 806,Sacramento,CA 95812-0806 PERMANENT STATE ID NUMBER APPLICATION Please type or neatly print in ink. Please review the line-by-line instructions carefully. NEW NUMBER REQUESTS Check all that apply (See instructions.) ❑ 1. 1 am applying for a new permanent California ID number as a hazardous waste: ❑ Generator ❑ Transporter Reason for new number: A. ❑ Never had a number B. ❑ Business moved C. ❑ Legal owner of business changed If your business generates greater than 100 kg of RCRA hazardous waste other than those hazardous waste listed in 40 CFR 261.5 subparts(c)and(d),per month, complete Form 8700-12 for an EPA(federal)ID number. CHANGES TO STATUS OR INFORMATION FOR AN EXISTING STATE ID NUMBER (See instructions.) For existing ID number: C A .L 0 0 0 3 4 8 8 2 4 ❑ 2. 1 am updating the mailing address and/or contact information only. ❑ 3. 1 am inactivating this ID Number, 2 4. 1 am reactivating this ID Number. Reason (please select one): A. ❑ Verification Questionnaire B. 2 Other ❑ 5. 1 am changing the business name only, no ownership change. 6. Site/Facility/Business Name(Include DBA): Silvestre's Mechanical Company Inc. (See instructions.) _ 7. site Location. 6030 E. Kettleman Lane Street LodiCA 95240 San Joaquin City 8. (a)Federal Employer ID Number (b)Board of Equalization Fee Account Number ((b)is only required from generators of greater than 5 tons per calendar year) 9. Mailing Address: PO BOX 2507 (See instructions.) Street Lodi CA 95241 City State Zip 10. Site Contact Person: Melinda Hernandez (See instructions.) First Name Last Name Contact Person Address: PO BOX 2507 LS$edf CA 95241 City State Zip Contact Person Phone Number: (209 ) 333-2608 X 702 855 444-7624 Fax Number: (�� Area Code Phone Number Area Code Fax Number Contact Person Business Email Address:mhernandez@silvestresmechanical.comPreferred Primary Communication: c Mail F. Email 11. Legal Business Owner(not property owner): Sllvestre Hernandez (See instructions.) Owner Address: PO Box 2507 Name Lodi CA 95241 Streel City State Zip Owner Phone Number: (209 ) 327-0749 Fax Number: SL 55 t 444-7624 Area Code Phone Number Area Code Fax Number 12. Standard Industrial Classification (SIC)Code for the Site: 3 5 8 5 (4-Digit Number) (See instructions.) 13. Certification: I certify under penalty of law that the information on this document was prepared to the best of my knowledge and belief to be, true, accurate a d complete. SIGNATURE DATE 04/13/17 NAME (print)_Sllvestre rna eZ TITLE President & CEO PHONE 209-327-0749 DTSC Form 1358(01/17)