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California Environmental Protection Agency Department of Toxic Substances Control OEIM — Business Operations Unit Page 1 of 3 Permanent State ID Number Application (DTSC Form 1358) Instructions Do not use DTSC Form 1358 to apply for a temporary State ID number or to apply or make changes to a federal EPA ID number. Line 1 — New Number Requests • If you are applying for a new permanent State ID number, check this box. Select generator, transporter or both, and select the reason you are applying. • You cannot apply for a new permanent State ID number and the inactivation of an existing permanent State ID number on the same application. Two separate applications must be submitted. Lines 2-5 — Changes to Status or Information for an Existing State ID Number • Check the appropriate box to update, inactivate or reactivate a permanent State ID number or to change the business name only. • A permanent State ID number is specific to the location and owner to which it is assigned. If your business has moved or had a change in ownership, you must apply for a new permanent State ID number. • You may change the business name without applying for a new permanent State ID number if there has been no change in legal ownership. Line 6 — Site/Facility/Business Name • Enter the legal name of the site/facility/business, this may include a Doing Business As (DBA). Line 7 — Site Location • Enter the site/business location address, including the name of the county. • A permanent State ID number is specific to the location and owner to which it is assigned. If your business has moved or had a change in ownership, you must apply for a new permanent State ID number. • The address must be a physical address with a street number and street name. If there isn't a physical address, latitude and longitude or assessor's parcel number is acceptable. • Post office boxes or descriptive addresses are not acceptable. Line 8 — Federal Employer ID Number/ California Department of Tax and Fee Administration (CDTFA) Number • Enter the Federal Employer ID Number (FEIN), also known as the Federal Tax Identification Number. If the business is a sole proprietor and does not have a FEIN, enter"sole proprietor" or "N/A". This field is required and cannot be left blank.