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RECEIV <br />UNIFIED PROGRAM CONSOLIDATED FORM MAY 2 <br />FACILITY INFORMATION <br />BUSINESS OWNER/OPERATOR IDENTIFICATION <br />SAN JOAQUIN <br />05/05/2009 - 08:31:50 AM <br />Page o <br />I. IDENTIFICATION <br />FACILITY ID# 13759 1 1 <br />BEGINNING DATE N/A 100 <br />101 <br />ENDING DATE N/A <br />BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 <br />BUSINESS PHONE 102 <br />AT&T MOBILITY-HWY 4& KAISER RD <br />800-638-2822 *2 <br />BUSINESS SITE ADDRESS 103 <br />BUSINESS FAX 102a <br />7575 E HWY 4 <br />Not Collected <br />BUSINESS SITE CITY104 <br />ZIP CODE 105 <br />COUNTY 108 <br />STOCKTON <br />CA <br />95215 <br />SAN JOAQUIN <br />DUN & BRADSTREET 106 <br />PRIMARY SIC 107 <br />PRIMARY NAICS 107a <br />10-202-6754 <br />4812 <br />Not Collected <br />BUSINESS MAILING ADDRESS 108a <br />4430 ROSEWOOD DR <br />BUSINESS MAILING CITY 108 <br />STATE 108cZIP <br />CODE 108d <br />PLEASANTON <br />CA <br />94588 <br />BUSIN S OPERATOR NAME 109 <br />BUSINESS OPERATOR PHONE 110 <br />AT&T MOBILITY <br />510-305-2553 <br />II. BUSINESS OWNER <br />OWNER NAME (14) 111 <br />OWNER PHONE (15) 112 <br />CINGULAR & NEW CINGULAR DBA <br />♦ T O_T 1R/An TT 11`l) <br />510-305-2553 <br />OWNER MAILING ADDRESS 113 <br />4430 ROSEWOOD DRIVE, BLDG.3, 6TH FLR. <br />OWNER MAILING CITY 114 <br />STATE 115 <br />ZIP CODE 116 <br />PLEASANTON <br />CA <br />94588 <br />III. ENVIRONMENTAL CONTACT <br />CONTACT NAME 117 <br />CONTACT PHONE 118 <br />EH&S - ANDREW TAYLOR <br />925-823-6161 <br />CONTACT MAILING ADDRESS 119 <br />CONTACT EMAIL 119a <br />2600 CAMINO RAMON RM - <br />o Trnnn <br />stephen.lockert@stantec.com <br />CONTACT MAILING CITY 120 <br />STATE 121 <br />ZIP CODE 122 <br />SAN RAMON <br />CA <br />94583 <br />IV. EMERGENCY CONTACTS <br />NAME ELLEN MAGNIE 123 NAME <br />ROBERT GARZA 128 <br />TITLE l24 TITLE <br />129 <br />COMPLIANCE MANAGER <br />OPERATIONS MANAGER <br />BUSINESS PHONE 510-305-2553 125 BUSINESS <br />PH NE 925468-8499 13 <br />24-HOUR PHONE 800-638-2822 *2 126 24-HOUR <br />PHONE 866-435-7347 131 <br />PAGER # 510-305-2553 127 1PAGER <br /># 415-999-2672 132 <br />ADDITIONAL LOCALLY COLLECTED INFORMATION: 133 <br />COMPLETE PAGE 2 OF BUSINESS OWNER/OPERATOR IDENTIFICATION <br />Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law by signing below or certifying by the <br />established processes on the Administerting Agency's HMMP Compliance Website that I have personally examined and am familiar with the informaiton submitted and <br />believe the information is true, accurate, and complete. <br />SIGNATURE OF OWNER/OPERATO R DESI TED REP ESENTATIVE <br />DATE 1 <br />ME OFDOCUMENT PREPARER 135 <br />,ig 1 � <br />NAME OF SIGNER tSTIEVESKANDERS0N 136 <br />rITLE OF SIGNER 13' <br />UPCF (Rev. 12/2007) <br />T-\/ <br />