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State of California—California Environmerotection Agency Department of Toxic Substances Control-GISS — _,,, , P.O.Box 806,Sac amento,CA 95812-0806 Reset FO - FEE.ran CALIFORNIA HAZARDOUS WASTE PERMANENT ID NUMBER APPLICATION Please type or neatly print in ink. Please review the line-by-line instructions carefully. To check on the status of your request.do to www.hwts.dtsc.ca. ov and click on Reports. NEW NUMBER REQUESTS Check all that apply. (See instructions.) ❑ 1. 1 am applying for a new permanent California ID number as a hazardous waste: ❑ Generator []Transporter Reason for new number. A. ❑ Never had a number B. ❑ Business moved C. ❑ Legal owner of business changed If your business generates greater than 100 kg of RCRA hazardous waste per month, contact US EPA for a federal/D number. CHANGES TO STATUS OR INFORMATION FOR AN EXISTING ID NUMBER (See instructions.) For existing ID number: C A _p_ Q Q Q J_ 5 -3- --L 3— -5-- ❑ 2. 1 am updating the mailing address and/or contact information only. ❑ 3. 1 am inactivating this ID Number. 4. 1 am reactivating this ID Number. ❑ 5. 1 am changing the business name only, no ownership change. (See instructions.) f 6. Site/Facility/Business Name(include DBA): Amina Maat Pg Ctiing r-ompany Tnr^ 7. Site Location: 9900 Lower Sacramento Rd. StNFVton - CA 95210 San Joaquin City State Zip County 8. (a)Federal Employer ID Number Board of Equalization Fee Account Number ((b)is only required from generators of greater than 5 tons per calendar year) (See instructions.) 9. Mailing Address: 9900 Lower Sacramento Rd. Street 95210 C_�tyt t6n CA City Slate Zip 10. Site Contact Person: Alice Kae s l i n (See instructions.) First Name Last Name Contact Person Address: 9900 Lower Sacramento Rd. Street 95210 St- ktnn CA City State Zip Contact Person Phone Number. ( 2041477-2691 x 2 4 5_ Fax Number: CLO 9) 477-1994 Area Code Phone Number Area Code Fax Number Contact Person Business Email Address: alive@alpinemeats.colQefered Primary Communication:®Mail ❑Email _ (See instructions.) 11. Legal Business Owner(not property,owner): Shareholders 9900 Lower Sacramento Rd. Owner Address: Stocictnn CA 9571 n Street City State I Zip Owner Phone Number. ( 9n41 477-2601 Fax Number. (209) 477-1994 Area Code Phone Number Area Code Fax Number 12. Standard Industrial Classification(SIC)Code for the Site: 2 (L _J_ _3_ (4-Digit Number) (See instructions.) 13. Certification: I certify under penalty of law that the information on this document was prepared to the best of my knowledge and belief to be, true, accurate and comp l t . SIGNATURE � l DATE 8 0 I t ( Q NAME(print) N TITLE S kir PHONE 0,0 1 X z¢5 DTSC Forth 1358(6108)