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Exhibit CA — Corrected DTSC Form 1358 Page 4 <br /> State of California California Environmental Protection Agency <br /> PERMANENT STATE ID NUMBER APPLICATION Department of Toxic Substances Control <br /> DTSC Form 1358(Revision 12/2021) Page 1 of 2 <br /> IMPORTANT: Please read the instructions before completing this form. Fill out this form <br /> completely and accurately. Incomplete and inaccurate forms will be rejected.All fields <br /> are required except those indicated as optional. <br /> NEW NUMBER REQUESTS. Check all that apply <br /> ❑ 1. I 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 /> CHANGES TO STATUS OR INFORMATION FOR AN EXISTING STATE ID NUMBER <br /> For existing ID number(include the lettered prefix): CAL000282527 <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. a)Site/Facility/Business Name(include DBA): Johan Food&Fne1Stop <br /> b) Business Type: ❑Sole Proprietor ®Corporation ❑Partnership ❑LLC ❑Other <br /> 7. Site Location: 24323 N Highway 99 <br /> Street <br /> Acampo CA 95220 United States <br /> City State ZIP Code County <br /> 8. a) Federal Employer ID Number(FEIN): (38-0459777 <br /> b) CA Secretary of State Filing/Entity Number(if applicable): C2261256 <br /> c)CDTFA Account Number(if applicable): <br /> 9. Mailing Address: 94222 N Highway 9q <br /> Street <br /> Cit�campo State CA ZIP Code95242 <br />