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Send Result Report 19KYOCERa <br />AM <br />'TASKeffa60526 w2D7902268 <br />05/17/2018 11:34 <br />Firmware Version 2ND 2000.E03.007 2018.01.05 [2N0 1c00.003.0211 [2N0_1100.901.0071 [2N0_7000.001.0�21 <br />Job No.: 012198 Total Time: 0°00'57" Page: COT <br />No Response <br />Document: doc01219820180517113335 <br />� S1aFB of California-CaOfornln £nvimnrnenlalPmiectlon A(Mn�Y bepertmm�c of 70HIC 6upstenoes GDntn51- 01$I <br />ReS4t Form a P•0. Box 1308, Swxnnanto, CA 051512-0505 <br />CALIFORNIA HAZARDOUS WASTE PERMANENT ID NUMBER APPLICATION <br />Peace type or noatlp print In Irdc Ploose vvww the 4ne�bydim Instructions cefalmly. <br />To 01 -wick on the statue of your MuGgL ou to YAwftat kamay and dick on Ropurls. <br />NeN NUMBER REQUESTS Chack Al awl apply, (";go irlatrycflons.) <br />Q 1. I am applying for a new permanent California ID numb8r ea a hazardous wa9te: ❑ CfirArator ❑Teenepprtof <br />( Reason for new number. A. ❑ Never had a number B. l f Business moved C. ❑ Legal owner of business d 4nged <br />N your bt&rmss generates giostar Man 100 kg of RGR4 hazardous wash pw month, con a Us EPA for a fed"I ID i7UMtW <br />GES TO STA R INF R N R (SeeInefrpoNals.) <br />For exlstng ID number. C A !D _ r 0 I 1— <br />® 2. 1 am updating the mailing addrose ontlRlr donut fnrormation only. <br />❑ 3, 1 am Ineceva0ng this ID Number. <br />13 4. (sm rsafCi wiog this ID Nvmber. <br />S.' 1 em changing the business name only, no ovmershlp change. <br />t <br />5, Site/Faoil'ty 8uaineas Nam(Include DHA):-1t944I.1 NS�ifiTh'11t j CSG. !tea InsWobans) <br />�. sitsLoeatian, ayt��-. muaipbs� 'Rig <br />6t�1 <br />CMyrr�� 5(sle Zip County <br />8. (a) Federal Employer ID Numner (& � Foard of equalization Fee Account Number <br />((d) is ontY Mufr19d thane WOMtOrs W r Men f 100 Of C6firxfpr fir. <br />No. Date/Time Destination <br />001 05/17/18 11:3319162554703 <br />Times Type Result <br />0°00'57" FAX BUSY <br />Resolution/ECM <br />200x100 Normal/Off <br />