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FROP1 : " FAX NO. : 12093690153 Sep. 25 2003 01:30PM P2 <br /> 09/25/2008 THU 12: 11 FAX 20946, .33 SJC EHD 2002/003 <br /> 01/25/20pR TRU 12:07 FAX 2094683433 SJC Ps FCD �OOL <br /> �_ _ --- <br /> k***wwaR*:4 x*,P*A,**k**w <br /> A•k i f AR TX REPORT k k k <br /> •R'hkk*'h***,.**'k kk k***** <br /> TRANSMISSION UK <br /> J013 NO. 1863 <br /> DESTINATION ADDRESS 919162554703 <br /> PSWD/SUBADDCtS4S <br /> DESTINATION 10 <br /> t;rr TIME 09/25 12z06 <br /> USAGE T 00' 25 <br /> PGfi. 1 <br /> RESULT OK <br /> Donarunent of'roxlr.Substances control,aISS <br /> State of CallforNa-California Environmental ProtuGlon Agency P.C.Box 306•Sacramento.CA 05102-0300 <br /> Reset Form Print <br /> CALIFORNIA HAZARDOUS WASTE PERMANENT ID NUMDER APPLICATION <br /> Blease type or noatly print in Ink- Ploase reviow the line-byllne Instructions carefully. <br /> To rhack on Uto status of our request 9a to W w.hwt A(ec.ca.gov ant!click an eoorts- _, <br /> (See in9frucfi0ns.) <br /> r1.NL,MBE RE yrsCheck all that apply tam applying for a now permanent California ID number as a hazardous waste: Generator E]Tt'ansporter <br /> Reason for now number; A. [g Never had a number 13. [] Business moved G. []Legal owner of busineeti changed <br /> if your brlSinG9S enerat®s r9ator than 100 k of RCRA hazardous waste Pei'month.contact US GPA for a federal!D number. <br /> M Soe instructions,) <br /> Qj4ANGES S S OR FOR TION FU AN XIS G ID NUMBER -� <br /> For existing 10 number: C A <br /> r] 2. 1 am updating the mailing address and/or c tact Informatlon only. <br /> [] 3, 1 am inactivating this ID Number. <br /> Cl 4, 1 am reactivating thin ID Number. <br /> Q cj- I am ottenging the business name Otily,no ownership change. —�_ .-.._. <br /> "-�- <br /> • �" insfructlons,) <br /> f� <br /> SiteiFaciiity/Business Name(Inctude D9A); -< ED <br /> I. Site Location, t' r \(� '=• c)`( - <br /> .. County fr > c <br /> ..,._ ..._State l,Ip <br /> City _� <br /> <br /> (b}Board of CquallZation Fee Account Number_ �Z -r' <br /> k only required from(enerators of greater than t5 tons per calendar V ar,) <br /> -- (Sea Instructions.) <br /> g. Mailing Address: <br /> street <br /> -.L)—A-, Zip.)_'_.. <br /> City <br /> (See instructi0ns.) <br /> 10, Site Contact Person last Nam <br /> First Name ) <br /> Contact Person Address: <br /> City State > ZIP <br /> FAL« O�;` f_�.r, Fax Numaor (�)t I��:,�c� "-. c`� •�'__ <br /> Contact Person Phone Number: �) ••-��- Area Ca CIO rax NumBor <br /> Arae Cada Phone ntumbar \ \... <br /> Contact Parson Business Finall Address' L �r �' ` \� ' A ' Preferred Peimsfy CommUnicatlan: Mail ( L it <br /> (Soe in9frurtiOnsJ <br /> 11. Legal Business Owner(not preporly owner);• <br /> I ..- <br /> / NAAnn • C ) } \ <br /> OwnarAddress: �� r� _.1J�--�' �' "� c E•)�_�.�..� C' -- `.'.�l'2..1, <br /> lin <br /> $treatr � - �.. .,, .- City ,Xr5 talar ! r <br /> )U 7•-'.., Fax Number <br /> owner Phone Nume ber: ( C(Ca 1 <br />