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BUSINESS IDENTIFICATION FORM Page 2 of 3 <br /> NUMBER (35) <br /> EXTREMELY HAZARDOUS SUBSTANCES (EHS) <br /> ON-SITE EH&S (36) If yes, and above Threshold Quantities, attach a sheet of paper with a general <br /> description of the process and principle equipment. <br /> DDITIONAL LOCALLY COLLECTED INFORMATION (37) <br /> NAME OF DOCUMENT PREPARER <br /> (38) DEC 1008 <br /> NAME OF OWNER/OPERATOR 39 DATE 40 SANjoAQ <br /> BUSINESS MAILING AND BILLING INFORMATION 8GENCY-owl r <br /> SERV ES <br /> MAILING ADDRESS (41) <br /> (If different from Site Address(6), otherwise leave blank.) <br /> NOTE: ALL TIME SENSITIVE AND OFFICIAL CORRESPONDENCE WILL BE SENT TO THIS ADDRESS <br /> P.O. BOX 604 <br /> STREET NUMBER DIRECTION STREET NAME STREET TYPE <br /> CLEMENTS CA 95227 <br /> CITY STATE ZIP <br /> BILLING ADDRESS (42) <br /> (If different from Mailing Address(41), otherwise leave blank,) <br /> NOTE;INCLUDE "CARE OF" INFORMATION <br /> STREET NUMBER DIRECTION STREET NAME STREET TYPE <br /> CITY STATE ZIP <br /> ADDITIONAL BUSINESS INFORMATION <br /> PE OF Q Single Owner 0 Corporation 0 Partnership Public Agency <br /> ORGANIZATION (43) <br /> UNSTAFFED SITE <br /> NETWORK (44) <br /> ASSESSOR PARCEL NO. (45) <br /> PROPERTY OWNER PHONE NO. (47) <br /> NAME (45) <br /> PROPERTY OWNER <br /> ADDRESS (48) <br /> http://sjoesdata.org/oes_hmmp/section_tables/CHMIRF_ps_review.lasso?-Database ran... 12/31/2008 <br />