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State of California—California Environmental Protection Agency Department of Toxic Substances Control <br /> Office of Environmental Information Management <br /> Permanent State ID Number Instructions and Application (DTSC Form 1358) <br /> 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. <br /> Item# Section <br /> 1 New Number 0 If you are applying for a new permanent State ID number,check this box.Select Generator, <br /> Requests Transporter or both,and select the reason you are applying. <br /> • You cannot apply for a new permanent State ID number and the inactivation of an existing <br /> permanent State ID number on the same application.Two separate applications must be submitted. <br /> 2-5 Changes to Status or • Check the appropriate box to update,inactivate or reactivate a permanent State ID number or to <br /> Information for an change the business name only. <br /> Existing State ID . A permanent State ID number is specific to the location and owner to which it was assigned.If your <br /> Number business has moved or had a change in ownership,p,you must apply for a new permanent State ID <br /> number. <br /> • You may change the business name without applying for a new permanent State ID number if there <br /> has been no change in ownership. <br /> 6 Site/Facility/Business • Enter the legal name of the site/facility/business,this may include a Doing Business As(DBA). <br /> Name <br /> 7 Site Location • Enter the site/business location address,including the name of the county. <br /> • A permanent State ID number is specific to the location and owner to which it was assigned.If your <br /> business has moved or had a change in ownership,you must apply for a new permanent State ID <br /> number. <br /> • The address must be a physical address;street number and street name.If there is no physical <br /> address,latitude and longitude or assessor's parcel number is acceptable. <br /> • Post office boxes or descriptive addresses are not acceptable. <br /> 8a— Federal Employer ID • Enter the Federal Employer ID Number(FEIN),also known as the Federal Tax Identification Number. <br /> 8b Number If the business is a sole proprietorship and does not have a FEIN,enter"sole proprietorship"or <br /> Board of Equalization "N/A".This field is required and cannot be left blank. <br /> (BOE) Number a A BOE Number,also known as a hazardous waste generator fee account number is only required if <br /> your business generates or produces five or more tons of hazardous waste per calendar year, <br /> regardless of the final waste disposition.DTSC notifies the California State Board of Equalization <br /> (BOE)when a State ID number has been issued.To apply for a BOE Number or for more information, <br /> please visit www.boe.ca.gov. <br /> • If the business does not have a BOE Number,this field will be blank. <br /> 9 Mailing Address . Enter the mailing address.This address may be different from the site location address. <br /> 10 Site Contact • Enter the site contact person's name,address,and phone number. <br /> Information a Entering an email address and fax number are recommended if available. <br /> 11 Legal Business a Enter the legal business owner's information.If the business is a corporation,enter the company's <br /> Owner legal business name.Example:Mike's Bikes,Inc. <br /> • Do not enter the property owner or management company since they are not the entity generating <br /> hazardous waste. <br /> • DTSC does allow a change in ownership to an immediate family member without issuing a new <br /> permanent State ID number. <br /> • If there has been a change in ownership,you must apply for a new permanent State ID number. <br /> 12 Standard Industrial • Enter your 4-digit Standard Industrial Classification(SIC)Code.The SIC Code best describes your <br /> Classification(SIC) company's primary business activity.To search for your SIC Code please visit <br /> Code for the Site https://www.osha.gov/pls/imis/sicsearch.html. <br /> 13 Certification . The application must include a hand-written signature of an owner,officer or employee of the <br /> business or an authorized consultant.DTSC does not accept digital signatures. <br /> • Enter the date,name,title,and phone number of the person who is signing. <br /> 'lication SubhMsion <br /> Postal Mail Email Fax <br /> Department of Toxic Substances Control idnumberPdtsc.ca.gov (916)323-3500 <br /> OEIM—Business Operations Unit,11th Floor <br /> P.O.Box 806 An email submission is recommended for DTSC does not confirm receipt of faxes. <br /> Sacramento,CA 95812-0806 trackability. <br /> DTSC does not confirm receipt of mail. <br /> Instructions for DTSC Form 1358(9/18) Page 1 of 3 <br />