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State of California—California Environmen' otection Agency Department of Toxic Substances Control-GISS Reset Form Print 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.dtsg.ca.gov 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, contact US EPA for a federal ID number. CHANGES TO STATUS OR INFORMATION FOR AN EXISTING ID NUMBER (See instructions.) For existing ID number: C A ❑ 2. 1 am updating the mailing address and/or contact information only. ❑ 3. 1 am inactivating this ID Number. ❑ 4. 1 am reactivating this ID Number. ❑ 5. 1 am changing the business name only, no ownership change. Paper (See instructions.) P a 6. Site/Facility/Business Name(Include DBA): Internationalp 7. Site Location: 400 W. Valpico Road Street Tracy CA 95376 San Joaquin City State Zip County 8. (a) Federal Employer ID Number/ � Board of Equalization Fee Account Number ((b)is only required from generators of greater than 5 tons per calendar year.) 9. Mailing Address: 400 W. Valpico Road (See instructions.) Street Tracy CA 95376 City State Zip 10. Site Contact Person: Jim Dacayanan (See instructions.) First Name Last Name Contact Person Address: 400 W. Valpico Road Street Tracy CA 95376 City State Zip Contact Person Phone Number: 2( O9 ) 836-6181 Fax Number: 2( O9 ) 836-6160 Area Code Phone Number Area Code Fax Number Contact Person Business Email Address: jim.dacayanan@ipaper.com preferred Prima Communication: Primary []Mail ✓❑Email (See instructions.) 11. Legal Business Owner(not property owner): International Paper Name Owner Address: 6420 Poplar Avenue Memphis TN 38197 Street City State Zip Owner Phone Number: 9( 01 ) 419-9000 Fax Number: 9( 01 ) 419-4730 Area Code Phone Number Area Code Fax Number 12. Standard Industrial Classification (SIC) Code for the Site: 2 6 5 3 (4-Digit Number) (See instructions.) 13. Certification: 1 certify under penalty of law that the information on this document was prepared to the best of my knowledge and belief to be, tru curate cbmfrlete. SIGNATURE DATE NAME(print) ,COIL(, L'� 5 TITLE Zi�>-At PHONE 2,0'9 DTSC Form 1358(6/08)