Laserfiche WebLink
BUSINESS OWNER/OPEIAOOR IDENTIFICATION PAGE (• SIDE 2 <br /> BUSINESS MAILING AND BILLING INFORMATION <br /> MAILING ADDRESS(41) , 11 / <br /> (If different from Site Address) S W a mm!v G f <br /> NOTE: All time sensitive and Street No. Direction Street Name Street Type <br /> official correspondence will � <br /> be sent to this address J4(,t� h © I <br /> CITY STATE ZIP <br /> BILLING ADDRESS(42) <br /> If different from above, <br /> include"Care of information c <br /> ADDITIONAL BUSINESS INFORMATION <br /> TYPE OF ❑Single Owner ❑Partnership I UNSTAFFED SITE NETWORK(44) YES ®NO <br /> ORGANIZATION (43) 1E]Corporation ❑Public Agency <br /> ASSESSOR PARCEL NO.(45) <br /> PROPERTY OWNER (46) r PHONE NO. (47) <br /> NAME A J �A �n e k r Se J 707— SS <br /> (If different from Business Owner) 7— I'9 <br /> PROPERTY OWNER (48) <br /> ADDRESS <br /> / V005,0pins✓ 6F04 <br /> Street Address <br /> e 14,yo G C/--5-c <br /> CITY STATE ZIP <br /> FIRE DISTRICT (49) <br /> NEAREST CROSS (50) _ <br /> STREET -- r <br /> FACILITY (51) IF YES, <br /> LOCK <br /> BOX AYES NO WHERE IS IT LOCATED?(52) <br /> NATURE OF BUSINESS (53) <br /> i T",J , CC <br /> WASTE GENERATOR (54) IF YES, <br /> ES � WHAT IS YOUR EPA NO.?(55) <br /> TRAINING PROGRAM INFORMATION <br /> Does your business have an employee training program that includes initial training and annual refreshers? (56) yES �NO <br /> Doei,#Q l3asiness maintain written training records that show the training subject,date(s)of training, (57) YES �NO <br /> names.and signatures of employees trained,and names of instructor(s)? <br /> uV Z SJC 12/97 <br /> tvk98 <br /> r ;EtiS <br />