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`t-703 <br /> State of California—Calirornia Environmental Protection Agency , 7' Dep1ment of Toxic Substances Control <br /> GISS <br /> P.O.Box 806 <br /> Sacramento,CA 95812-0806 <br /> California Hazardous Waste Permanent ID Number Application <br /> Please review the line-by-line instructions carefully. <br /> New Number Requests. Check all that apply. (See instructions.) <br /> D 1. I am applying for a new permanent California ID number as a hazardous waste: &- e'nerator iJ Transporter <br /> Reason for new number: A. n Never had a number B. 17 Business moved C. ❑ Legal owner of business changed <br /> Chances to Status or Information. (See instructions.) <br /> For ID number: C A <br /> 2. lam updating the mailing address and/or contact information only. <br /> 3. 1 am inactivating this ID Number. A <br /> ( (A < <br /> 4. I am reactivating this ID Number. e.,Jf t',� 6 <br /> 5. I am changing the business name. There has been no ownership change. <br /> 6. This site is a: Generator of less than 1,000 kg/month California-only waste (See instructions.) <br /> J Generator of greater than 1,000 kg/month California-only waste <br /> -1 Conditionally Exempt Small Quantity Generator of RCRA Waste <br /> 7. Site/Facility Name: Q- l 190 n( ,S K C L.- L. <br /> 8. Site Location: 3 4 rn A i N S(R C C t <br /> Street <br /> le l P o >-4 C i14" cf ,A.&J J-1) 4 CQO I N Cizi <br /> City State Zip County <br /> S ►�'l,tr 4 V G (See instructions.) <br /> 9. Mailing Address: _ <br /> Street <br /> City State Zip <br /> 10. Site Contact Person: (3 A L,A ZT"t' <br /> N G k c (See instructions.) <br /> First Name Last Name <br /> Contact Person Address: 3 Co N c7 1r,R"` <br /> Stre am- Ltd— cr I,J <br /> r-4,ek City State Zip <br /> Contact Person Phone Number: Fax Number: (S LD)-7 <br /> Area Code Phone Number Area Code Fax Number <br /> y Contact Person Business Email Address: N/ A <br />