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10/06/2011 THU 10:12 FAX 2094683433 SJC EHD 2001 <br />********************* <br />*** FAX TX REPORT *** <br />********************* <br />TRANSMISSION OK <br />JOB NO. <br />4390 <br />DESTINATION ADDRESS <br />919162554703 <br />PSWD/SUBADDRESS <br />DESTINATION ID <br />ST. TIME <br />10/06 10:11 <br />USAGE T <br />00'26 <br />PGS. <br />1 <br />RESULT <br />OK <br />09/27/2011 16:51 209-833-1002 TRACY POWER EQUIP PAGE 01/01 <br />State of California — California Environmental Protection Agoncy Department of Toxic Substances Control - GISS <br />*00ITLtTm ;,ul P.O. Box 806, Sacramento, CA 95912-0806 <br />CALIFORNIA HAZARDOUS WASTE PERMANENT ID NUMBER APPLICATION <br />Pleaue type or neatly print in Ink. Please review the Ina -by-line instructions carefully, <br />To check on the status of your request, oo to www,hwts.dtsc.ca.aov and cllck on Reports <br />NEW NUMBER RE4UESTS Check all that apply, (See instructions.) <br />F1 1. 1 am applying for a new permanent California ID number as a hazardous waste: Q Generator Transporter <br />Reason for new number. A. [] Never had a number B. L1 Business moved C. ❑ Legal owner of business changed <br />If your business generates greater than 100 kg of RCRA hazardous waste per month, contact US EPA fora federal ID number, <br />UNANGtS VU STA- US UK INFUYZMAIIUN FUK AN EXISIING ID VV <br />For existing ID number: G A L..— 0 _Q_ _ I-1,tLa— <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 (Incllu--de��DRA,,)'. <br />7. Site Location: � _S Lj'A1C,' <br />city <br />3. (a) Federal employer ID <br />, instructions.) <br />t, kms, <br />8 2!111 <br />13AN'i0/1i1L;;� <br />� ����� (See'fris"trllCtrons.) <br />tate Zip County <br />Board of Equalization Fee Account Number <br />is only required from generators of groater than 5 tons per calendar year.) <br />9. Mailing Address; (� (See instructions.) <br />J��s� <br />Street <br />City State Zip <br />10. Site Contact Person: <br />Contact Person Address <br />(See instructions.) <br />Contact Person Phone Number. ( _6: - I0 00 Fax Number: ( ) (� _- 002 - <br />Area <br />OZArea Code Phone Number Area Code Fax Number <br />--kW RCdfS �iCG Preferred Primary Communication! ❑Mail (E•Finail <br />Contact Person Business email Add ress �—�r <br />11. Legal Business Owner (not property owner), <br />Name <br />Owner Address: l <br />Street <br />Owner Phone Number. (7n71Atl/ 4_ <br />City Stale <br />(See instructions.) <br />