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State of California-California Environmental Protection Agency Department of Toxic Substances Control-GISS <br /> P.O.Box 806,Sacramento,CA 95812-0VI(f <br /> ' CALIFORNIA HAZARDOUS WASTE PERMANENT ID NUMBER APPLICATION n i/'�j <br /> Please type or neatly print in ink. Please review the Ilne-by-line instructions carefully. —e1���1. <br /> To check on the status of our request, o to www.hw s.dtsc.ca. v and click on Reports. <br /> NEW NUMBER REQUESTS Check all that apply. (See instructions.) <br /> 1. 1 am applying for a new permanent California ID number as a hazardous waste: 11 Generator ❑Transporter <br /> Reason for new number: A. 8 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 per month, call(415)495-8895 for a federal/D number. <br /> CHANGES TO STATUS OR INFORMATION FOR AN EXISTING ID NUMBER (See instructions.) <br /> For existing ID number. C A <br /> ❑ 2. 1 am updating the mailing address and/or contact information only. <br /> ❑ 3. 1 am inactivating this ID Number. <br /> ❑ 4. 1 am reactivating this ID Number. <br /> ❑ 5. 1 am changing the business name only, no ownership change. <br /> 6. Site/Facility/Business Name(Include DBA): Dehal Trucking LLC. (See instructions.) <br /> 7. Site Location: 11500 S. Harlan Rd. <br /> Street <br /> Lathrop CA 95330 San Joaquin <br /> City State Zip County <br /> 8.(a)Federal Employer ID Number 47-1206858 (b)Board of Equalization Fee Account Number <br /> ((b)is only required from generators of greater than 5 tons per calendar year.) <br /> 9. Mailing Address: 1993 Lugano Way (See instructions.) <br /> Street <br /> Manteca CA 95337 <br /> City State Zip <br /> 10. Site Contact Person: Hardeep Singh (See instructions.) <br /> First Name Last Name <br /> Contact Person Address: 11500S. Harlan Rd. <br /> Street <br /> Lathrop CA 95330 <br /> City State Zip <br /> Contact Person Phone Number: (_g09 ) 983-9600 Fax Number: 2f 09 ) 983-9606 <br /> Area Code Phone Number Area Code Fax Number <br /> Contact Person Business Email Address:dehaltrucking(d_)oullook.Gom Preferred Primary Communication: n Mail A Email <br /> 11. Legal Business Owner(not property owner): Jugiit Singh (See instructions.) <br /> Name <br /> Owner Address: 1993 Luciano Way Manteca CA 95337 <br /> Street City State Zip <br /> Owner Phone Number: 2f 09 ) 983-9600 Fax Number. (209 ) 983-9606 <br /> Area Code Phone Number Area Code Fax Number T <br /> 12, Standard Industrial Classification(SIC)Code for the Site. 4 2 3 1 (4-Digit Number) (See instructions.) <br /> 13. Certification: /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 a orn tete, <br /> SIGNATURE_ _DATE 12-02-2014 <br /> NAME(print) Hardeep Singh TITLE Manager PHONE 209-983-9600 <br /> DTSC Form 1358(10112) —�- <br />