Laserfiche WebLink
Permanent State ID Number Application <br />DTSC Form 1358 (Revision 05/20) <br />California Environmental Protection Agency <br />Department of Toxic Substances Control <br />Page 1 of 2 <br />NEW NUMBER REQUESTS. Check all that apply <br />❑ 1. 1 am applying for a new permanent State ID number as a hazardous waste: <br />❑ a) Generator ❑ b) Transporter <br />Reason for a new number: <br />❑ a) Never had a number ❑ b) Business moved ❑ c) Legal business owner changed <br />If your business generates greater than 100 kg of RCRA hazardous waste other than those <br />hazardous wastes listed in 40 CFR 261.5subparts (c) and (d) per month, complete the EPA <br />Form 8700-12 for a federal EPA ID number. <br />CHANGES TO STATUS OR INFORMATION FOR AN EXISTING STATE ID NUMBER <br />For existing ID number (include the lettered prefix): ( A ��►C <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): �'Onuj C, <br />7. Site Location: L�> V�-'� �J� r( <br />Stre t <br />City State ZIP Code County <br />8. a) Federal Employer ID Number: <br />b) CDTFA Account Number: <br />This is only required from generators of greater than 5 tons per calendar year. <br />9. Mailing Address: Tn 1�(� <br />4n iStreet C4 <br />City State ZIP Code <br />