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BUSINESS OWNERIOPERATOR IDENTIFICATION PAGE SIDE 2 <br /> BUSINESS MAILING AND BILLING INFORMATION L�, ��Da JrCt � SQ <br /> �If 8iffebeneYro�t Sl��ddtess �0 0 J � Jf�J <br /> Street No. Direction Street Name Street Type <br /> l SDC jG 7� l� <br /> ,, � FEB 141991 Cil Q��-v � <br /> CITY STATE ZIP <br /> j Bir�G n>?izEs�(azxs <br /> Imo ' a ve; 03 �Q 0Q)J },/\J Pt1�L C �b rJ Go=l 410 <br /> include"Care of information p <br /> ADDITIONAL BUSINESS INFORMATION <br /> TYPE OF UNMANNED SITE NETWORK(44) YES O <br /> ORGANIZATION(43) re 0 Q UJ Cori Lau <br /> BUSINESS LICENSE NO. (45) G EXPIRATION DATE(46) <br /> ASSESSOR PARCEL NO. (47) <br /> PROPERTY OWNER (48) �j PHONE NO. (49) <br /> (If different rent from Business Owner) G lid �0flo " I do lII 0 v� <br /> PROPERTY OWNER (50) <br /> ADDRESS „) p� �✓ <br /> V / Street Address <br /> s �CIC 4a � C �( Ll <br /> CITY STATE ZIP <br /> FIRE DISTRICT (51) <br /> NEAREST CROSS (52) J <br /> STREET C <br /> FACILITY (53) �Y//ES NO IF YES, <br /> LOCK BOX WHERE IS IT LOCATED?(54) <br /> NATURE OF BUSINESS (55) <br /> G) <br /> WASTE GENERATOR (56) �H�id IF YES, <br /> WHAT IS YOUR EPA NO.?(57) <br /> TRAINING PROGRAM INFORMATION <br /> Does your business have an employee training program that includes initial training and annual refreshers? (58) DYES [:JNO <br /> Does your business maintain written training records that show the training subject,date(s)of training, (59) YES �NO <br /> names and signatures of employees trained,and names of instructor(s)? <br /> SIC 12/96 <br />