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PRINT CLEAR <br /> Stale of California—Califomie Environmental Agency _ ( Department of Toxics Substances Control <br /> J� 2s <br /> Certified Aooliance Recvcler Application <br /> Please aubml[to: <br /> Department of Toxic Substances Control <br /> Attn: HWMP-CAR application <br /> '1001 "I"Street, 17`^ Floor <br /> P.O. Box 806 <br /> Sacramento, California 95872-0806 <br /> or <br /> CARt�dtsc.ca.00v <br /> Before you may remove"materials that require spacial handling"(MRSH)from a major appliance,you must be <br /> approved as a Certified Appliance Reeycler(CAR),pursuant to Haalth end Safety Cotler Sactioo 2527 7 at seq. (AB <br /> 7447,20D7). Vou muss also provide evitlanea of your CAR status to the scrap metal facility. <br /> Ones a certificate is issued, DTSC will notify the certified uniform program agency(COPA)in your jurisdiMion <br /> responsible for Inapecfing the eartiTietl appliance recycling facility. <br /> Certificates issued will ba valid for three years. Once your cartificatlon has azpirad,you era no longer a CAR. In <br /> order[o oontinua operating as a CAR,you must renew your eertifieatlom before the azpiration data. <br /> Plaeae nota: Any ehan9as to the information provided on the Cartiried Appliance Reeyelar Application must ba <br /> submitted[o DTSC in order for the certification to ba valid. <br /> Q Renewal CAR Nu mbar:394 Q Naw CAR Number• <br /> Plaasa nota: Entlra application must be completed. <br /> 7. Business Information <br /> Business name under which the applicant operates: SImS LirOUp USA C:OrPOratlOn <br /> PnyalealAddrasa: 1000 S. Aurora St_, Stockton, CA 95206 <br /> Mailing Address: same <br /> Business Phono Number: 209-948-4000 Business OwnarNama� Sims Group USA Corporation <br /> owner Addrasa: 600 S. 4th St. Richmond, CA 94804 <br /> Owner Phone Number: S'10-412-$3OO Emall Address(if available): <br /> 2. Hazareous Wastes Generator identification Number: CAD029495074 <br /> 3. Have filed for a storm water permit? � Ves or Q Not required to obtain <br /> 4. Have filatl a hazartlous materials business plan? xQ Yas or 0 Not required to file <br /> B. Tax Idantifieafion number, assigned by the Franchise Tax Board: 1 1 99523 <br /> 6. A[taeh a copy of a business license. <br /> 7. Attach a copy of conditional use permits issuetl by the appropriate city or county, if applicable. <br /> DTSC 7428(07/70/2079) Page 7 of 2 <br />