DTSC Form 1358 "Permanent State Id Number Application" - California

What Is Form DTSC1358?

This is a legal form that was released by the California Department of Toxic Substances Control - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2018;
  • The latest edition provided by the California Department of Toxic Substances Control;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form DTSC1358 by clicking the link below or browse more documents and templates provided by the California Department of Toxic Substances Control.

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Download DTSC Form 1358 "Permanent State Id Number Application" - California

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State of California – California Environmental Protection Agency
Department of Toxic Substances Control
Office of Environmental Information Management
Permanent State ID Number Instructions and Application (DTSC Form 1358)
Do not use DTSC Form 1358 to apply for a temporary State ID number or to apply or make changes to a federal EPA ID number.
Item #
Section
1
New Number
If you are applying for a new permanent State ID number, check this box. Select Generator,
Requests
Transporter or both, and select the reason you are applying.
You cannot apply for a new permanent State ID number and the inactivation of an existing
permanent State ID number on the same application. Two separate applications must be submitted.
2 – 5
Changes to Status or
Check the appropriate box to update, inactivate or reactivate a permanent State ID number or to
Information for an
change the business name only.
Existing State ID
A permanent State ID number is specific to the location and owner to which it was assigned. If your
Number
business has moved or had a change in ownership, you must apply for a new permanent State ID
number.
You may change the business name without applying for a new permanent State ID number if there
has been no change in ownership.
6
Site/Facility/Business
Enter the legal name of the site/facility/business, this may include a Doing Business As (DBA).
Name
7
Site Location
Enter the site/business location address, including the name of the county.
A permanent State ID number is specific to the location and owner to which it was assigned. If your
business has moved or had a change in ownership, you must apply for a new permanent State ID
number.
The address must be a physical address; street number and street name. If there is no physical
address, latitude and longitude or assessor’s parcel number is acceptable.
Post office boxes or descriptive addresses are not acceptable.
8a –
Federal Employer ID
Enter the Federal Employer ID Number (FEIN), also known as the Federal Tax Identification Number.
8b
Number
If the business is a sole proprietorship and does not have a FEIN, enter “sole proprietorship” or
Board of Equalization
“N/A”. This field is required and cannot be left blank.
(BOE) Number
A BOE Number, also known as a hazardous waste generator fee account number is only required if
your business generates or produces five or more tons of hazardous waste per calendar year,
regardless of the final waste disposition. DTSC notifies the California State Board of Equalization
(BOE) when a State ID number has been issued. To apply for a BOE Number or for more information,
please visit www.boe.ca.gov.
If the business does not have a BOE Number, this field will be blank.
9
Mailing Address
Enter the mailing address. This address may be different from the site location address.
10
Site Contact
Enter the site contact person’s name, address, and phone number.
Information
Entering an email address and fax number are recommended if available.
11
Legal Business
Enter the legal business owner’s information. If the business is a corporation, enter the company’s
Owner
legal business name. Example: Mike’s Bikes, Inc.
Do not enter the property owner or management company since they are not the entity generating
hazardous waste.
DTSC does allow a change in ownership to an immediate family member without issuing a new
permanent State ID number.
If there has been a change in ownership, you must apply for a new permanent State ID number.
12
Standard Industrial
Enter your 4-digit Standard Industrial Classification (SIC) Code. The SIC Code best describes your
Classification (SIC)
company’s primary business activity. To search for your SIC Code please visit
Code for the Site
https://www.osha.gov/pls/imis/sicsearch.html.
13
Certification
The application must include a hand-written signature of an owner, officer or employee of the
business or an authorized consultant. DTSC does not accept digital signatures.
Enter the date, name, title, and phone number of the person who is signing.
Application Submission
Postal Mail
Email
Fax
Department of Toxic Substances Control
idnumber@dtsc.ca.gov
(916) 323-3500
OEIM – Business Operations Unit, 11th Floor
P.O. Box 806
An email submission is recommended for
DTSC does not confirm receipt of faxes.
trackability.
Sacramento, CA 95812-0806
DTSC does not confirm receipt of mail.
Instructions for DTSC Form 1358 (9/18)
Page 1 of 3
State of California – California Environmental Protection Agency
Department of Toxic Substances Control
Office of Environmental Information Management
Permanent State ID Number Instructions and Application (DTSC Form 1358)
Do not use DTSC Form 1358 to apply for a temporary State ID number or to apply or make changes to a federal EPA ID number.
Item #
Section
1
New Number
If you are applying for a new permanent State ID number, check this box. Select Generator,
Requests
Transporter or both, and select the reason you are applying.
You cannot apply for a new permanent State ID number and the inactivation of an existing
permanent State ID number on the same application. Two separate applications must be submitted.
2 – 5
Changes to Status or
Check the appropriate box to update, inactivate or reactivate a permanent State ID number or to
Information for an
change the business name only.
Existing State ID
A permanent State ID number is specific to the location and owner to which it was assigned. If your
Number
business has moved or had a change in ownership, you must apply for a new permanent State ID
number.
You may change the business name without applying for a new permanent State ID number if there
has been no change in ownership.
6
Site/Facility/Business
Enter the legal name of the site/facility/business, this may include a Doing Business As (DBA).
Name
7
Site Location
Enter the site/business location address, including the name of the county.
A permanent State ID number is specific to the location and owner to which it was assigned. If your
business has moved or had a change in ownership, you must apply for a new permanent State ID
number.
The address must be a physical address; street number and street name. If there is no physical
address, latitude and longitude or assessor’s parcel number is acceptable.
Post office boxes or descriptive addresses are not acceptable.
8a –
Federal Employer ID
Enter the Federal Employer ID Number (FEIN), also known as the Federal Tax Identification Number.
8b
Number
If the business is a sole proprietorship and does not have a FEIN, enter “sole proprietorship” or
Board of Equalization
“N/A”. This field is required and cannot be left blank.
(BOE) Number
A BOE Number, also known as a hazardous waste generator fee account number is only required if
your business generates or produces five or more tons of hazardous waste per calendar year,
regardless of the final waste disposition. DTSC notifies the California State Board of Equalization
(BOE) when a State ID number has been issued. To apply for a BOE Number or for more information,
please visit www.boe.ca.gov.
If the business does not have a BOE Number, this field will be blank.
9
Mailing Address
Enter the mailing address. This address may be different from the site location address.
10
Site Contact
Enter the site contact person’s name, address, and phone number.
Information
Entering an email address and fax number are recommended if available.
11
Legal Business
Enter the legal business owner’s information. If the business is a corporation, enter the company’s
Owner
legal business name. Example: Mike’s Bikes, Inc.
Do not enter the property owner or management company since they are not the entity generating
hazardous waste.
DTSC does allow a change in ownership to an immediate family member without issuing a new
permanent State ID number.
If there has been a change in ownership, you must apply for a new permanent State ID number.
12
Standard Industrial
Enter your 4-digit Standard Industrial Classification (SIC) Code. The SIC Code best describes your
Classification (SIC)
company’s primary business activity. To search for your SIC Code please visit
Code for the Site
https://www.osha.gov/pls/imis/sicsearch.html.
13
Certification
The application must include a hand-written signature of an owner, officer or employee of the
business or an authorized consultant. DTSC does not accept digital signatures.
Enter the date, name, title, and phone number of the person who is signing.
Application Submission
Postal Mail
Email
Fax
Department of Toxic Substances Control
idnumber@dtsc.ca.gov
(916) 323-3500
OEIM – Business Operations Unit, 11th Floor
P.O. Box 806
An email submission is recommended for
DTSC does not confirm receipt of faxes.
trackability.
Sacramento, CA 95812-0806
DTSC does not confirm receipt of mail.
Instructions for DTSC Form 1358 (9/18)
Page 1 of 3
State of California – California Environmental Protection Agency
Department of Toxic Substances Control
Office of Environmental Information Management
Additional Information
The application processing time is up to 15 business days from the date your application is received by DTSC.
To check the status of your permanent State ID number, visit the following links: (Computer pop-up blockers may need to be disabled.)
o
By ID Number:
https://hwts.dtsc.ca.gov/report_search.cfm?id=2
o
By Company:
https://hwts.dtsc.ca.gov/report_search.cfm?id=5
There are no fees to obtain a permanent State ID number.
Please make a copy of your application for your records as DTSC will not provide a copy of your completed application.
Please review your application for completeness before submitting as incomplete applications will delay the processing.
Newly issued permanent State ID numbers will receive a confirmation notice by mail.
Reactivated or inactivated permanent State ID numbers will not receive written confirmation. You can check the status of your ID number
in one of the links above.
Questions? Please contact our Telephone Information Center at (800) 618-6942 or email us at idnumber@dtsc.ca.gov.
Page 2 of 3
Instructions for DTSC Form 1358 (9/18)
State of California – California Environmental Protection Agency
Department of Toxic Substances Control
Office of Environmental Information Management
PERMANENT STATE ID NUMBER APPLICATION
Please type or print legibly in ink.
NEW NUMBER REQUESTS
Check all that apply.
1. I am applying for a new permanent California ID number as a hazardous waste:
Generator
Transporter
Reason for a new number: A.
Never had a number B.
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, please complete Form 8700-12 for a federal EPA ID number.
CHANGES TO STATUS OR INFORMATION FOR AN EXISTING STATE ID NUMBER
C A
___ ___ ___ ___ ___ ___ ___ ___ ___ ___
For existing ID number:
2.
I am updating the mailing address and/or contact information only.
3.
I am inactivating this ID number.
4.
.
I am reactivating this ID number. Reason (
):
A
Verification Questionnaire
B.
Other
please select one
5.
I am changing the business name only, no ownership change.
6. Site/Facility/Business Name (
): ______________________________________________________________________
Include DBA
7. Site Location: ____________________________________________________________________________________________
Street
____________________________________________________________________________________________
Zip Code
City
State
County
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: __________________________________________________________________________________________
Street
__________________________________________________________________________________________
Zip Code
City
State
10. Site Contact Person: _____________________________________________________________________________________
First Name
Last Name
Contact Person Address: __________________________________________________________________________________
Street
__________________________________________________________________________________
Zip Code
City
State
Contact Person Phone Number: (_____) ________________________ Fax Number: (_____) ___________________________
Area Code
Phone Number
Area Code
Fax Number
Contact Person Business Email Address:______________________________________________________________________
11. Legal Business Owner
: _____________________________________________________________________
(not property owner)
Name
Owner Address: _________________________________________________________________________________________
Zip Code
Street
City
State
Owner Phone Number: (_____) _____________________ Fax Number: (_____) _____________________________________
Area Code
Phone Number
Area Code
Fax Number
12. Standard Industrial Classification (SIC) Code for the Site:
___ ___ ___ ___
(4-Digit Number)
13. Certification: I certify under penalty of law that the information on this document was prepared to the best of my knowledge and
belief to be true, accurate and complete.
SIGNATURE (handwritten) _________________________________________________________ Date ____________________
Name (print) _________________________________ Title ________________________ Phone _______________________
DTSC Form 1358 (09/18)
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