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State of California — Califomia Environmental Protection Agency Department of Toxic Substances Control - HWMP P . O. Box 806 , Sacramento, CA 95812-0806 PERMANENT STATE ID NUMBER APPLICATION Please type or neatly print in ink. Please review the line-by-line instructions carefully. To check on the status of your request, <io to and click on Reports . NEW NUMBER REQUESTS Check all that apply. (See instructions.) 0 1 . 1 am applying for a new permanent California ID number as a hazardous waste : 0 Generator ❑ Transporter Reason for new number: A. ❑ Never had a number B . 0 Business moved C . ❑ Legal owner of business changed If your business generates greater than 100 kg of RCRA hazardous waste other than those hazardous waste listed in 40 CFR 261 . 5 subparts (c) and (d), per month, complete Form 8700- 12 for an EPA (federal) ID number. CHANGES TO STATUS OR INFORMATION FOR AN EXISTING STATE ID NUMBER (See instructions.) For existing ID number: C A . L_ O 0 0 1 4 5 5 5 5 0 2 . 1 am updating the mailing address and/or contact information only. ❑ 3 . 1 am inactivating this ID Number. ❑ 4 . 1 am reactivating this ID Number. Reason (please select one): A . ❑ Verification Questionnaire B . ❑ Other ❑ 5 . 1 am changing the business name only, no ownership change. 6. Site/ Facility/Business Name ( Include DBA) : MV TRANSPORTATION #9 (See instructions.) 7 . Site Location : 1250 S WILSON WAY SUITE AA Street STOCKTON CA 95205 SAN JOAQUIN ary State Zip County 94-2491705 8 . (a) Federal Employer ID Number (b) Board of Equalization Fee Account Number ( (b) is only required from generators of greater than 5 tons per calendar year. ) 9. Mailing Address : 2711 N HASKELL AVE SUITE 1500 LB -2 (See instructions.) Street DALLAS TX 75204 City State Zip 10 . Site Contact Person : HAROLD ALLAN (See instructions.) First Name Last Name Contact Person Address : 1250 S WILSON WAY SUITE A- 1 QUM STbCKTON CA 95205 City State Zip Contact Person Phone Number: ( 209 ) 941 - 1 639 Fax Number: ( 209 ) 547- 7880 Area Code Phone Number Area Code Fax Number Contact Person Business Email Address: hSallan@mytranSlt . COm Preferred Primary Communication: 6 Mail tn Email 11 . Legal Business Owner (not property owner) : ALEX LODDE (See instructions.) Owner Address : 2711 N HASKELL AWeSUITE 1500 LB -2 , DALLAS , TX 75204 Stree City State Zip Owner Phone Number: ( 72 ) 391 -4646 Fax Number: ( 972 ) 4324328 Area Code 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 : / certify under penalty of law that the information on this document was prepared to the best of my knowledge and belief to be, tru . , ccurat and com SIGNATURE — ` DATE NAME (print) HAROLD ALLAN TITLE Fleet manager PHONE 209941 - 1639 DTSC Form 1358 (01 / 17)