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r -- <br /> COMPREHENSIVE <br /> ENVIRONMENTAL SERVICES <br /> CLEANING& SPILL&HAZMAT DEGASSING& Contractor's License No.: <br /> DISPOSAL RESPONSE VAPOR CONTROL (A-HAZ)928436 <br /> Storage Tank Spill Response Thermal Oxidizer EPA I.D.NO.: <br /> Cleaning HazMat Cleaning Degassing Systems CAR000180737 <br /> Vacuum Truck &Packing Mobile Vapor Motor Carrier No.: <br /> Services CONFINED Control CA 320501 <br /> Roll Off Services SPACE RESCUE <br /> Robotic Manway SERVICES 17 DOT No.: <br /> 1785153 <br /> Cannons Vertical Entries <br /> MC No.: <br /> Horizontal Entries 650604 <br /> CERTIFICATION FOR PURCHASE OF REPORT BY MAIL <br /> Please complete the below and attach to your written request for a report copy.i <br /> I certify that I am a party of proper interest under Vehicle Code Section 20012 <br /> Check one: ❑Driver ❑Passenger ❑Owner ❑Family member ❑Pedestrian <br /> REQUESTER'S NAME(PRINT) SIGNATURE <br /> STREETADDRESS <br /> CITY,STATE AND ZIP CODE <br /> FINANCIAL RESPONSIBILITY INFORMATION <br /> California's Financial Responsibility Law requires you to report to the Department of Motor <br /> Vehicles(DMV)any traffic accident which results in damage to the property of any person in <br /> excess of$750 or in bodily injury or death. Use Form SR-1 which is available at all CHP and <br /> DMV offices. Law enforcement reports do not satisfy the DMV report requirement. Failure to <br /> submit the Form SR-1 to DMV may lead to the suspension of your driving privilege. <br /> e <br /> y <br />