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Facility Information Business Owner/Operator Notification: CERS Business Page 1 of 2 <br /> %W Iwo <br /> California Environmental Reporting System:Business �-myf Sion Out. Tools Renins IL_,Jp <br /> Home Submittals Facilities Compliance My Business <br /> Business Owner/Operator Identification: EDDIES PIZZA CAFE <br /> Home N Submitla tl� )) SubmittaC 5114/2015110180765) b Facility information:Business Owner/Operator IdeMdication(Submitted) <br /> 6lshvctiorts/Heip <br /> Use this farm to provide contact information about your facility.Your local regulator may require you to complete the property owner information,Assessor Parcel Number,Number <br /> of Employees,or Facility ID fields in the'Lccally-Collecled Fields"section at the bottom of the page. <br /> \ _ . <br /> Submittal Element Nialoasry <br /> Submitted for CERS ID 10180765 on 5/14/2015 11:05AM by Stove Clausen of EDDIES PIZZA CAFE(STOCKTON CAI <br /> Yiew Entre Suprmdal Bran New Sudniltal MAY 14 2 <br /> Site Address E NVIRONMENTA+. <br /> '.. EDDIES PIZZA CAFE <br /> 1419 S EL DORADO ST <br /> 6TOCKFON,CA 95206 <br /> Identification <br /> ESALOO,VICTOR <br /> Beginning Date Ml Ending Date sir <br /> Operator Phone Business Phone A Busineu Fax A <br /> (209)4624735 (209)465-3401 ()- Dun s Bredstre st 6 SIC Code A Primary NAICS 0 <br /> 0000 <br /> �Facility/Site Mailing Address Primary Emergency Contact <br /> PO BOX 6098 I Steve Clausen <br /> STOCKTON, CA 95206 nue <br /> Vice President <br /> mer Business Phone 24-Hour Phone fi Pager Number A <br /> EILRAI INC (209)4624735 (209)2716285 - <br /> Mone <br /> (2D9)4624735 1 -Secondary Emergency Contact <br /> Mailing Address I Marcos Madgrigal <br /> PO BOX 6098 Title ai <br /> STOCKTON, CA 95206 1 General Manager <br /> Business Phon is 24Hour Prone w Pager Numberap <br /> EDDIES PIZZA Ct <br /> Billing D — (209)462-1234 (209)623-7840 - <br /> PIZZA CAFE <br /> Phone Environmental Conct <br /> (209)4624735 Steve Clausen <br /> (209)4624735 <br /> Mailing Address <br /> PO BOX 6098 Mailing Address <br /> STOCKTON, CA 95206 1419 S EL DORADO ST <br /> STOCKTON, CA 95206 <br /> Name of Signer 1r Tale of Signer 4 Name 0f Document Preparer A <br /> Steve Clausen Vice President Steve Clausen <br /> Additional Information til <br /> ovally-Collected Information — <br /> Borne or all of Me following fields may be required by your local regulator(s). <br /> —Property Owner Assessor Parcel Number(APN)as <br /> Victor Esaloo 18702103 <br /> Phone Number of Employees G <br /> 23 <br /> (209)462-1234 <br /> Mailing Adtlress Facility ID Number(Regulator-pmA <br /> vided) <br /> 0180765 <br /> P.O.Box 5098 <br /> I Stockton. CA 95206 <br /> cnaM1tl it,Sew cleulen on Nfrza151:aa M ''.. <br /> lastuporea rt,stele Chosen on 5-42015413 PM <br /> Varsion?.230tKY I Eohancahmot I CERS Central ,ra, _ Dipgnnsti�s Crnldrtrons of Usa Pnvacv Po!icv i Conlad HelO <br /> L��,.m, 41�Y CERS Help lar Settings _rev Basi mer <br /> https://cersbusineSS2.calepa.ca.gov/49473/Facility/10180765/Submittal/FI/11773 31/Owner... 5/14/2015 <br />