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BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE Page 2 <br /> BUSINESS MAILING AND BILLING INFORMATION <br /> MAILING ADDRESS(41) 3851 FREEWAY BLVD <br /> If different from Site Address, <br /> otherwise leave blank Street No. Direction Street Name Street Type <br /> NOTE:All official mail will <br /> go to this address SACRAMENTO CA 195834 <br /> CITY STATE ZIP <br /> BILLING ADDRESS(42) <br /> If different from Mailing <br /> Address,otherwise leave blank Street No. Direction Street Name Street Type <br /> City State ZIP <br /> ADDITIONAL BUSINESS INFORMATION <br /> TYPE OF ❑Single Owner ❑Partnership UNSTAFFED SITE <br /> YES <br /> ORGANIZATION(43) IN Corporation ❑Public Agency NETWORK(44) <br /> ASSESSOR PARCEL NO. (45) 1206-040-05 <br /> PROPERTY OWNER (46) MARGARET J ROSE HALLMARK PHONE NO.(47) <br /> NAME ' <br /> (If different from Business Owner) <br /> PROPERTY OWNER (48) <br /> ADDRESS 112776 CASTLE RD <br /> Street Address <br /> IMANTECA CA 195336 <br /> City State ZIP <br /> FIRE DISTRICT NO. 111 NAMDISTRICT (49) FRENCH CAMP <br /> NEAREST CROSS (50) <br /> STREET FRENCH CAMP& CASTLE RD <br /> FACILITY (51) NO --J IF YES, N/A <br /> LOCK BOX WHERE IS IT LOCATED?(52) <br /> NATURE OF BUSINESS (53) <br /> TELECOMMUNICATIONS <br /> WASTE GENERATOR (54) NO IF YES, <br /> WHAT IS YOUR EPA NO.?(55) N/A <br /> TRADE SECRET (56) SPILL PREVENTION (57) 7 <br /> INFORMATION NO :1 AND COUNTERMEASURES NO <br /> PLAN FOR THIS FACILITY <br /> TRAINING PROGRAM INFORMATION <br /> Does your business have an employee training program that includes initial training and annual refreshers? (58) YES <br /> Does your business maintain written training records that show the training subject,date(s)of training, (59) Y S <br /> names and signatures of employees trained,and names of instructor(s)? <br />