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0 <br /> I � I-11 11 1 1 '."]BUSINESS OWNEK/OPERATOI2 IDENTIFICATION FORM Account#: 945( <br /> Primary Site#: 0 <br /> BEGINNING DATE(I) 2000 I. IDENTIFICATION DATE RECEIVED 2/27/01 <br /> BUSINESS NAME (4) BURGER KING #7628 BUSINESS PHONE(5) 209-367-7693 <br /> SITE ADDRESS (6) 18960 N❑ HWY 88 <br /> Street No. Drection Street Name Street T e A 1/Bld Suite <br /> CITY (7) LOCKEFORD STATE(g) CA ZIP(9) 95237 <br /> DUN (10>890406719026220 SIC CODE(4 DIGIT (11) 5812 <br /> BRADSTREET <br /> OPERATOR (12) KNOX & ASSOCIATES OPERATOR PHONE(13) 209-367-7693 <br /> NAME <br /> II. BUSINESS OWNER <br /> OWNER NAME(14) KNOX & ASSOCIATES OWNER PHONE(15) 209-367-7693 <br /> OWNER MAILING ADDRESS(16) 633 E VICTOR RD <br /> (If different from site address) <br /> CITY(17) FL ODI STATE(18) CA ZIP(19) 95240 <br /> III. ENVIRONMENTAL CONTACT <br /> CONTACT NAME(20) TODD KNOX CONTACT PHONE (21) 209-367-7693 <br /> MAILING ADDRESS (22) <br /> (If different from sit6 address) 6 3 3 E VICTOR KD <br /> Street No. Direction Street Name Street Type Apt/Bldg/Suite <br /> CITY(23) LODI STATE(24) CA ZIP(25) 95240 <br /> Primary IV. EMERGENCY CONTACTS Secondary <br /> NAME(26) TODD KNOX NAME(31) DAVE KNOX <br /> TITLE(27) DIR OF MAINT TITLE(32) DIR OF OPS <br /> BUSINESS PHONE(28) 209-367-7693 BUSINESS PHONE(33) 209-367-7693 <br /> 24-HOUR PHONE(29) 209-607-3200 24-HOUR PHONE(34) 209-483-1414 <br /> PAGER#(30) 209-775-7037 PAGER#(35) 209-775-7036 <br /> EXTREMELY HAZARDOUS SUBSTANCES (EHS) <br /> ON-SITE 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. <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION(37) Provide information requested on the back of this form <br /> NAME OF DOCUMENT PREPARER(38) TODD KNOX <br /> NAME OF OWNER/OPERATOR(39) KNOX & ASSOCIATES DATE(40) 2/1/1999 <br /> vl <br />