Laserfiche WebLink
4 6 9 <br />State of California — California Environmental Protection Agency Department of Toxic Substances Control <br />P.O. Box 806 <br />Sacramento, CA 95812-0806 <br />California Hazardous Waste Permanent ID Number Application <br />Please review the line -by-line instructions carefully and complete all items on the application. <br />New Number Requests. Check all that apply. (See instructions.) <br />[ ] 1. I am applying for a new permanent California ID number as a: [ ] Generator [ ] Transporter <br />Reason for new number: A. [ ] Never had a number B. [ ] Business moved C. [ ] Legal owner of business changed <br />Chanaes to Status or Information. (See instructions.) <br />For ID number: CA <br />[ ] 2. I am updating the mailing address and/or contact information only. <br />[ ] 3. lam inactivating this ID Number. <br />[ ] 4. I am reactivating this ID Number. <br />[ ] 5. lam changing the business name. There has been no ownership change. <br />8. Site Location: <br />First Name Last Name <br />Street <br />City <br />Contact Person Phone Number: ( <br />Area Code <br />Contact Person Business Email Address: <br />Preferred Primary Communication: [ ] Mail <br />11. Legal Business Owner (not property owner): <br />Name <br />Owner Address: <br />Street <br />Owner Phone Number: ( 1 <br />State Zip <br />Fax Number: <br />Phone Number <br />Area Code Phone Number <br />Email <br />(See instructions) <br />Area Code Fax Number <br />(See instructions.) <br />City State Zip <br />12. Standard Industrial Classification (SIC) Code for the Site: (4 -Digit Number) (See instructions) <br />DTSC 1358 10/03 <br />