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0 0 State of California—California Environmental Protection Agency Department of Toxic Substances Control-GISS P.O.Box 806,Sacramento,CA 95812-0806 CALIFORNIA HAZARDOUS WASTE PERMANENT ID NUMBER APPLICATION Please type or neatly print In Ink. Please review the line-by-line instructions carefully. To check on the status of your request,go to www.hwts.dtsc.ca. ov and click on Reports, 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 per month,call(415)495-8895 for a federal ID number. CHANGES TO STATUS OR INFORMATION FOR AN EXISTING ID NUMBER (See instructions.) For existing ID number: CA L 0 0 0 1 4 3 9 9 3 ❑ 2. 1 am updating the mailing address and/or contact information only. ❑ 3. 1 am inactivating this ID Number. 11 4. [am reactivating this ID Number. ❑ 5. 1 am changing the business name only,no ownership change. (See instructions.) 6. Site/Facility/Business Name(Include DBA): RMC Pacific Materials, Inc. 7. Site Location: 30350 South Tracy Blvd. Street Tracy CA San Joaquin City State ZIP County 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: 5180 Golden Foothills Parkway, Suite 200 (See instructions.) Street EI Dorado Hills CA 95762 city State Zip (See instructions.) 10. Site Contact Person: Bruce Eppley First Name Last Name Contact Person Address: 5180 Golden Foothill Parkway, Suite 200 Street EI Dorado Hills CA 95762 City State Zip Contact Person Phone Number: 9f 16 1 941-2920 Fax Number: (9, 16 1 939-7492 Area Code Phone Number Area Code Fax Number Contact Person Business Email Address:bruceh.eppler(G2gmail.com Preferred Primary Communication: a Mail n Email (See instructions.) 11. Legal Business Owner(not property owner): RMC Pacific Materials, Inc. Name Owner Address: 5180 Golden Foothill Parkway Suite 200 EI Dorado Hills, CA 95762 Street City State Zip Owner Phone Number: (.P16 ) 941-2920 Fax Number: (916 ) 939-7492 Area Code Phone Number Area Code Fax Number 12. Standard Industrial Classification(SIC)Code for the Site: 1 4 4 2 (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 and complete. SIGNATURE \L_ �__ DATE NAME(print) Bruce Eppler TITLE Environmental Manager PHONE(916)941-2920 DTSC Form 1358(10/12)