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FAccount#: <br /> I. IDENTIFICATION <br /> BUSINESS NAME (4) PIZZA FACTORY BUSINESS PHONE(5) 209-607-7787 <br /> SITE ADDRESS (6) 14088 FI <br /> HWY 88 =� <br /> Street No. Direction Street Name Street T e Apt/Bldg/Suite <br /> CITY (7) LOCKEFORD STATE(8) CA ZIP(9) 95209 <br /> DUN& (10) 131602989 SIC CODE(4 DIGIT#)(11) 5812 <br /> BRADSTREET <br /> OPERATOR (12) DANIEL NEHER OPERATOR PHONE(13) 209-607-7787 <br /> NAME <br /> II. BUSINESS OWNER <br /> OWNER NAME(14) DANIEL NEHER OWNER PHONE(15) 209-607-7787 <br /> OWNER MAILING ADDRESS (16) 14088 E HWY 88 <br /> (If different from site address) <br /> CITY(17) LOCKEFORD STATE(18) CA ZIP(19) 95237 <br /> III. ENVIRONMENTAL CONTACT <br /> CONTACT NAME(20) DANIEL NEHER CONTACT PHONE (2 1) 209-607-7787 <br /> MAILING ADDRESS(22) <br /> (If different from business ❑FBOX 1700 <br /> mailing address) Street No. Direction Street Name Street Type Apt/Bldg/Suite <br /> CITY(23) F <br /> STATE(24) E <br /> ZIP(25) 95640 <br /> Primary IV. EMERGENCY CONTACTS Secondary <br /> NAME(26) DAVIDFLORES NAME(31) DANIEL NEHER <br /> TTI'LE(27) MANAGER TITLE(32) OWNER <br /> BUSINESS PHONE(28) 209-727-3707 BUSINESS PHONE(33) 209-607-7787 <br /> 24-HOUR PHONE(29) 209-518-3210 24-HOUR PHONE(34) 209-607-7787 <br /> PAGER#(30) 209-603-5698CELL PAGER#(35) NA <br /> EXTREMELY HAZARDOUS SUBSTANCES (EHS) <br /> ON-Sr'E EHS (36) NO If yes,and above Threshold Planning Quantities,attach a sheet of paper with a general <br /> description of the process and principle equipment involving the EHS. <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION(37) Provide information requested on the back of this form <br /> NAME OF DOCUMENT PREPARER(38) DANIEL NEHER <br /> NAME OF OWNER/OPERATOR(39) DANIEL NEHER DATE(40) <br /> DATE RECD: 9/10/07 <br />