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03-24—'18 21 :47 FROM— T-065 P0006/0008 F-449 <br /> State of California—California Environm4&rotecrJon Agency • Department of Toxic Substancas Control-GISS <br /> P.O.Box 806,Sacramento,CA 95812-OM <br /> CALIFORNIA HAZARDOUS WASTE PERMANENT ID NUMBER APPLICATION <br /> Please We or neatly print in ink. Please review the lire-by-line instructions carefully. <br /> To check on the status o1 yRur ra oast,go to www.hwts-dtsc.ca.gov and dick on Reports. <br /> NEW NUMBER REQUESTS Check all that apply. (See instructions.) <br /> ❑ 1. I am applying for a new permanent California ID number as a hazardous waste: Q Generator ❑Transporter <br /> Reason for new number A. ❑ Never had a number B. ❑ Business moved C. ❑ Legal owner of business changed <br /> If your business generates greater than 100 kg of RCRA hazardous waste per month, cal! 415 495-8895 for a federal ID number. <br /> CHANCES TO STATUS ORINFORMATION FOR AN EXISTING ID NUMBER %� (Sa`s instn7ctons.) <br /> For existing ID number: C A I_. C7 1) Q a _ _L 5 � <br /> ❑ 2. I am updating the mailing address and/or contact information only. JUN 13 2016 <br /> ❑ 3. I am inactivating this ID Number. <br /> V 4. 1 am reactivating this ID Number- <br /> 0 <br /> umber❑ 5. 1 am changing the business name only, no ownership change. <br /> 6. Site/Facility/Business Name(rndude DBA): Jamar DBA Jay C Mcilrath Estate (See instructions.) <br /> 7, Site Location: 4075 L Main Street <br /> sheet <br /> Stockton CA 95215 San Joaquin <br /> City state Zip County <br /> 8.(a)Federal Employer ID Number 81--1845878 (b)Board of Equalization Fee Account Number <br /> ((b)is only required from generators of greater than 5 tons per cafen5r year.) <br /> 9. Mailing Address: PO BOX 326 <br /> See insbviWons.) <br /> street Stockton CA 95201 <br /> City State Zip <br /> 10. Site Contact Person: Jason 98tel (See instructions) <br /> First Name Last Name <br /> Contact Person Address: 1905 Navy Drive <br /> Strew <br /> Stockton CA 95206 <br /> CRY State Zip <br /> Contact Person Phone Number. 2( O9 1 462 8707 Fax Number: 2( O9 ) 462 6171 <br /> Area Code Phone Number Area Code Fax Number <br /> Contact Person Business Email Address: JSTEELCspcfuels.COru PWared Primary Communication: o Mail Ya Email <br /> 11. Legal Business Ownerof m Lori Toccoli (See instructions.) <br /> (n properly owner): <br /> 6966 Leesburg Place Stockton CA 95207 <br /> Owner Address: 8 e <br /> Owner Phone Number 209) 483-2533 Fax Number: 2l 09 ) %62 6171 z P <br /> Area Code Phone Number Area Code Fax Number <br /> 12. Standard Industrial Classification(SIC)Code for the She: 5 5 4 1 (4-Digit Number) (See instructors) <br /> 13. ca . certify under penalty of law that the information on this document was prepared to the best of my knowledge and <br /> alief to be, true, nd plete. <br /> $I NATURE C,l ecu�toor_ DATE June 7, 20160 <br /> NAME pant) �1. ) ld J TITLE /�ly _ PHONEQ'k3 If <br /> nTRr.gnm 1'3FA r1 n/40% <br />