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BUSINESS OWNER/OPERATOR 1 1 DATE REC'D 2/27/01 <br /> BUSINESS MAILING AND BILLING INFORMATION <br /> MAILING ADDRESS <br /> teAddr ) 633 � VICTOR RD <br /> If different from Site Address <br /> NOTE: All time sensitive and Street No. Direction Street Name Street Type <br /> official correspondence will be LODI CA 95240 <br /> sent to this address <br /> CITY STATE ZIP <br /> BILLING ADDRESS(42) <br /> If different from above; <br /> include"Care of information <br /> ADDITIONAL BUSINESS INFORMATION <br /> TYPE OF ❑Single Owner H Partnership UNSTAFFED SITE NO <br /> ORGANIZATION(43) ❑Corporation ❑Public Agency NETWORK(44) <br /> ASSESSOR PARCEL NO. (45) <br /> 051-300-21 <br /> PROPERTY OWNER (46) KNOX & ASSOCIATES PHONE NO. (47) <br /> NAME 209-367-7693 <br /> (If different from Business Owner) <br /> PROPERTY OWNER (48) <br /> ADDRESS 633 E VICTOR RD <br /> Street Address <br /> LODI CA 95240 <br /> CITY STATE ZIP <br /> FIRE DISTRICT NO. 13 N�ISTRICT (49) FKELUMNE FD <br /> NEAREST CROSS (50) <br /> STREET BRANT RD <br /> FACILITY (51) NO IF YES, <br /> LOCKBOX WHERE IS IT LOCATED?(52) <br /> NATURE OF BUSINESS (53) FAST FOOD <br /> WASTE GENERATOR (54) Nt0 IF YES, <br /> WHAT IS YOUR EPA NO.?(55) <br /> TRADE SECRET (56) SPILL PREVENTION (57) <br /> INFORMATION AND COUNTERMEASURES <br /> PLAN FOR THIS FACILITY <br /> TRAINING PROGRAM INFORMATION <br /> Does your business have an employee training program that includes initial training and annual refreshers? (58) YES <br /> Does your business maintain written training records that show the training subject,date(s)of training, (59) YES <br /> names and signatures of employees trained,and names of instructor(s)? <br />