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SEP -25-2007 10:01A FRDM:MR. B'S FFITERPRISES 209-941-4439 T0:4683433 P.1/1 <br />State of California -Cali fornia Environmental Protection Agency <br />Department of Toxic Substances Control - GISS <br />P.O. Box 806 <br />Sacramento. CA 95812.0806 <br />California Hazardous Waste Permanent ID Number Application <br />Please type or neatly print in ink Please review the line -by-line instructions carefully. <br />To check on the status of your request go to www hwts.dtsc ca.eov and click on Reports. <br />New Number Requests. Check all that apply. (See insintctions) <br />❑ I. I am applying for a new permanent California ID number as a hazardous waste: ❑ 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 titan /00 kg of RCRA hazardous waste per atonth, contact US EPA for a federal ID number. <br />Chao es to Status or Information for uxistin ID Number. (See instructions.) <br />For existing [D number: C A Q (�� <br />❑ 2. 1 am updating the mailing address and/or contact information only. <br />❑ 3. 1 am inactivating this ID Number. <br />plir 4. 1 am reactivating this ID Number. <br />❑ 5. 1 am changing the business name. There has been no ownership change. <br />(See instructions) <br />6. Site/Facility/Business Name (Include DBA): <br />7. Site Location:1�th� <br />e <br />TS 2-C& <br />City State Zip County <br />8. (a) Federal Employer ID Number: Zb (b) Board of Equalization Fee Account Number: <br />(b) is only required from generators ofgreater than S tons per calendar year.) <br />p6�� (See instructions.) <br />9. Mailing Address: Ip//(1)(�, <br />� , <br />City State Zip <br />10. Site Contact Person: <br />Contact Person Addres <br />Contact Person Phone Number:?( Ot) QU�•-� �3 Fax Number: ( 2001) q01-11430 <br />Area Code Phone Number Area Code Fax Number <br />Contact Person Business Email Adi <br />Preferred Primary Communication: <br />11. Legal Business Owner (not p operty owner): <br />Owner Address: 31 V M% 'N <br />Street q <br />Owner Phone Number: ( 704) ti t. <br />Area Code Phan <br />O Email <br />Fax Number: <br />Area <br />l2. Standard Industrial Classification (SIC) Code for the Site: (4 -Digit Number) (See instructions.) <br />DTSC Form 1358 (5/07) www.dtse.ca.gov <br />