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State of California—California Environmental ection Agency apartment of Toxic Substances Control-GISS Reset Form IPrint J.Box 806,Sacramento,CA 95812-0806 CALIFORNIA HAZARDOUS WASTE PERMANENT ID NUMBER APPLICATION P ase type or neatly print in ink. Please review the line-by-line instructions carefully. To check on the status of your request,go to www.hwts.dtsc.ca.gov 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. 0 Never had a number B. El Business moved C. E] Legal owner of business changed If your business generates great r than 100 kg of RCRA hazardous waste per month, contact US EPA for a federal ID number. CHANGES TO STATUS OR IN ORMATION FOR AN EXISTING ID NUMBER (See instructions.) For existing ID number: CA I L 0 0 0 1 6 1 0 7 5 E] 2. 1 am updating the mailing'address and/or contact information only. E] 3. 1 am inactivating this ID Number. E] 4. 1 am reactivating this ID Number. 5. 1 am changing the business name only, no ownership change. 6. Site/Facility/Business Name(I dude DBA): MARTINI'S AUTOMOTIVE, INC. (See instructions.) 7. Site Location: 4032 N. EL DORADO STREET Street CA 95204 SAN JOAQUIN STOCKTON City State Zip County 8. (a)Federal Employer ID Numbler 71-0938188 Board of Equalization Fee Account Number ((b)is only required from generators of greater than 5 tons per calendar year) 9. Mailing Address: 4032 N. EL DORADO STREET (See instructions.) Street STOCKTON CA 95204 City State Zip 10. Site Contact Person: MIC IAEL MARTINI (See instructions.) First Name Last Name Contact Person Address: 4032 N. EL DORADO STREET Street SJOCKTON CA 95204 City State Zip Contact Person Phone Numt�r. 2( 29 ) 462-8696 Fax Number: 2( 09 ) 462-3845 Area Code Phone Number Area Code Fax Number Contact Person Business Email Address: martinisautomotive@9mail.com Preferred Primary Communication:[Z]Mail [--]Email (See instructions.) 11. Legal Business Owner(not pr perty owner): Name Owner Address: Street City State Zip Owner Phone Number: (, ) Fax Number: ( ) Area ode Phone Number Area Code Fax Number 12. Standard Industrial Classification(SIC)Code for the Site: 7 5 3 8 (4-Digit Number) (See instructions.) 13. Certification: I rtify un er penalty of I w hat the information on this document was prepared to the best of my knowledge and belief to rue, e a pt - SIGNATU E DATE NAME(print) TITLE l.i ��'� PH0NE�� 7 DTSC Form 1358(6/08)