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I rant <br />State of California — California Environmental Agency <br />Department of Toxics Substances Control <br />Y,k1Kbt <br />"` f <br />CertifiedApplaneecycferA�,1ic� <br />Please submit to: <br />Department of Toxic Substances Control <br />Attn: HWMP - CAR Application <br />1001 "I" Street, 11'h Floor <br />P.O. Box 806 <br />Sacramento, California 95812-0806 <br />or <br />CAR�a.dtsc ca aov <br />Before you may remove "materials that require pecfal handling" <br />apprance <br />oved as a Certified Appliance Recycler (CAR), pursuant to Health and rSafety Code secom a major Jtion 25You 211 et seq., <br />be <br />(AB 1447, 2007). You "must also provide evidence of your CAR status to scrap metal facility. , q <br />Once a certificate is issued, DTSC will notify the certified uniform program agency (CUPA) in your jurisdiction <br />responsible for inspecting the certified appliance recycling facility. <br />Certificates issued will be valid for three years. Once your certification has expired, you are no longer a CAR <br />In order to continue operating as a CAR, you must renew your certification before the expiration date. <br />Please note:, Any changes to the information provided on the Certified Appliance Recycler Application must be <br />submitted to DTSC in order for the certification to be valid. <br />�✓ Renewal CAR Number: Q363 ---`T <br />QNew CAR Number: <br />1. Business <br />Please note: Entire application must be completed. <br />Information <br />Business name under which the applicant operates::Universal Sei <br />Physical Address: 3200 S. EI Dorado St. Stockton, CA 95206 <br />Mailing Address: 3200 S. EI Dorado. St. Stockton, CA 95206 <br />Vie. Rec lin inc. <br />Business Phone Number: 209 944-9555. <br />.�_ Business Owner Name: William Mendonca <br />Owner Address: 3200 S. EI Dorado St. Stockton, CA 95206 <br />Owner Phone Number: (209) 944-9555 Email Address (if available): sslater _usrscrap.com <br />2. Hazardous Waste Generator Identification NumberCAL000355717 <br />3. Have filed for a storm water permit? o Yes or <br />Not required to obtain <br />4. Have filed a hazardous materials business plan?Yes or (� <br />U Not required to file <br />5. Tax identification number, assigned by the Franchise Tax Board: <br />6, Attach a copy of a business license, <br />7. Attach a copy of conditional use permits issued by the appropriate city or county, if applicable. <br />DTSC 1428 (07/10/2019) <br />Pagel <br />or 2 <br />