Laserfiche WebLink
r 1 - <br /> s <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> FACILITY INFORMATION " <br /> BUSINESS OWNER/OPERATOR IDENTIFICATION,PAGE 2 <br /> LOCALLY COLLECTED INFORMATION <br /> (01/17/2012- 01:42:01 PM) <br /> TYPF�OF '138JUNSTAFFED SITh NEI WORK 139 <br /> ORGANIZATION ❑Single Owner .❑Partnership <br /> ®Corporation ❑Public Agency NO <br /> ASSESSOR PARCEL NUMBER 140 NEAREST CROSS STREET 141 <br /> 092-220-26-8 HAMMER LANE <br /> PROPERTY OWNER NAME(If different from Business Owner) J 42 PHONE NO. 143 <br /> MIKE OLAVARI N/A <br /> PROPERTY OWNER STREET ADDRESS 144.1PROPERTY OWNER CITY 145 STATE 146 ZIP CODE 147 <br /> PO BOX 591 SARATOGA CA 95071 <br /> FIRE DI&I'RICT NAME 148 FIRE DEPT'NO. 149 FACILITY LOCK BOX 150 IF YES.WHERE IS IT LOCATED? 151 <br /> STOCKTON 3108 NO NIA <br /> NATURE OF BUSINESS 152 <br /> i <br /> AUTO TUNE.-UP <br /> WASTE GFNFRA'TOR 153 IF YES.ENTER EPA NUMBER 154 <br /> YES CAL000336061 <br /> TRADE SECRE'l'INFORMATION 155 SPILL PREVEFIJTJON AND COUNTERMEASURES PLAN PREPARED FOR FACILITY? 156 <br /> NO NO <br /> TRAINING PROGRAM INFORMATION 157 <br /> Does your business have an employee training program that inCludcS initial training-and annual refreshers? YES <br /> Does your business maintain written training records that show the training sub,jecl,date(s)of training, YES <br /> names and signatures of employees trained,and names of instnictor(s)?. <br /> BILLING ADDRESS If different from Mailing Address,otherwise leave blank <br /> BUSINESS BILLING ADDRESS 158 <br /> 3031 STANFORD RANCH ROAD STE.2-144 <br /> BUSINESS BILLING CITY 159 STATE 160 ZIP CODE 161 <br /> ROCKLIN CA 95765 <br /> This area intentionally left blank <br />