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Aamco Transmission Record ID# PR0527567 May 20, 2019 Program: HW 2589 E Waterloo Rd. Stockton, CA PHOTO 17: DTSC form 1358 was filled out and faxed to the DTSC while inspector was on site to reactivate State ID: CAL000410671 VillilAS7E M�A sm.n/ceubma-eamam;ar ^m^Tal o I Mn P r'M.1.900 J��6V5 PERMANENT STATE ID NUMBER APPLICATION NEWNUMBER REO ST a iii[II not ao^ly--�s � "T�nm is�,uy!r_,a. _ J()rt 1. I am applying fqr a new permanent Caliromla ID number ae a haiardous waefe'm Generator O TraniplvYr Roason for a new numbers q_O Nevar had a number B. C]Business moved C.❑Legat ovmer N buaNep rJssli6a'd Il ypur busness generefes graefar then -6 subpads(c)erM(d)par month B oI RCRA hazerdo✓s wears omer Ihen trwea nazartbue wears Ibf W in a0 CFR 261.5 _ Please complete Form aJOq-12 to,a tedeml EPA ID number. OF 8 i STA For axlaling 10 number: L`A MATO FOR ANE IST NG STA E ID NU`�MBER t'L'ASTE MANIFEST 4�rn ❑2. I am updating the mailing address and/or contact lntprmeuon bnly CODE ❑3. 1 am inactivating Nis ID number. S 30" y $ 1 _ 4. I am reactivating this 1D number.Reason(please salec[one). A r�Verillwbon Ouaslionnaire B. Char _ 221 t �js f�c � _ ❑ S.I am changing the business name hl _�f 33 I Y.no ownership change. I � a 223 6.Site/Faclliry/Business Name(Includa DBA): 1 Ali Oil d�R---4awl 1;.!/h%L,mss• 7.Site Location: d Ic .� a r1s�oS s'`y�,bo.s Sim~- Fee Acc 8.(a)Federal Employer r ID Number (b)Board of Equalization F Account Number \ L ((b)is only required from generators of greater than 5 tons per calendar year.) p , ��w 9.Mailing Address: (� 7Sgr E VAT,lit+ Seim T CIt Siete e 2 Coda 9 I fees d court action TOTAL 7 .Customeragrees ropey en raga 10.Site Contact Persons he total halide co^te^tis LES than l,ol First ame Last N e d above with env other hazardous waste,t gems..regulation to determine thl ants of the applicable California used uil mans Contact Person Address: �t' eif[he inlormatio^l have provided about this waste is mc"nect. Str ferator,I certify Mat 1 haves program in Place m reduce the volume and dsp,al' t'[ `��m Zip Code3 City - bare ttl[hat/have selected Me practicable method of treatment Ithave made a eood J5 p and the envrronmenr.Or,ill am a small quartim, ^eraror' Contact Person Phone Number. ( ) 9��— f 9� I Fax Number:(—) ;ethod that is available to me that 1 can afford. A ea ode P ane Num1er—� Area Code Fax Number Contact Person Business Email Address: r Valley Waste oil will submit confirmation far(certain waste streams)to NC 11. Legal Business Owner(not property ower): J' GENERATOR' DATE: Name 'f AUTHORIZED — Owner Address: t Stale Zip Coda SIGNATURE: � / Sheet City V Owner Phone Number: ( _) Fax Number: (_) Area Code Phone Number Area Code Fax Number 'ERPRISES CORP SSE ST. 12. Standard Industrial Classification(SIC)Code for the Site: _ _ _ (4-Digit Number) CA 91352 13. Cert fication:I certify under penalty of law that the information on this document was=th 379059 belief to be true,accurate and complete. S SIGNATURE(handwritten) Name(print) Title p1� V 11 c; MIN �; o DISC Form 1358(09/18) o Page 3 of 3 ad WJEIL- � C n J VIA A. u Tricia Dai, EHS Page 17 of 17