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UNIFIED PROGRAM CONSOLIDATED FORM <br /> FACiIJTV INFORMATTnN <br /> BUSINESS OWNER/OPERATOR IDENTIIIFICATION <br /> Last Website Update: 12/22/2Q7 t I Page_ of <br /> I. IDENTIFICATION <br /> rA('I1 ITY M4 12035 1 RFMNNTNn DATE N/A 100 ENDING DATE N/A 101 <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doine Business As) 3 BUSINESS PHONE 102 <br /> EXEL(IMPERIAL) 209-942-0102 <br /> RTTCINFCR CtTF.AnnRFSS 103 BUSINESS FAX <br /> 3735 IMPERIAL WAY Not Collected <br /> BUSINESS SITE CITY 104 7TP rnnF 105 COUNTY 108 <br /> STOCKTON CA 95215 SAN JOAOUIN <br /> DUN&BRADSTREET 106 PRIMARY SIC 107 PRIMARY NAICS 107a <br /> 03-623-5240 4222 Not Collected <br /> RT ISINFRC M A IUN(T A r)nR FCR I ORa <br /> 3735 IMPERIAL WAY <br /> BUSINESS MAILING CITY 1081 STATE I III ZIP CODE 108d <br /> STOCKTON CA 95215 <br /> BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PHONE 110 <br /> EXEL INC 209-942-0102 <br /> II. BUSINESS OWNER <br /> OWNER NAME(14) 111 I OWNER P"I)NF r 111 112 <br /> EXEL INC 614-865-8500 <br /> OWNER MAIT.TN(; ADDRFCR 113 <br /> 570 POLARIS PARKWAY <br /> nWNFR MATI.Mr,CTTV 114 STATE 115 7TP(.nnF 116 <br /> W ESTERVILLE OH 43082 <br /> III. ENVIRONMENTAL CONTACT <br /> CONTACT NAME 117 1 CONTACT PHONE 118 <br /> BOB CHILCOTE 209-942-0102 EXT 121 <br /> CONTACT MAILING ADDRESS 110 CONTACT EMAIL 1 T9a <br /> 3735 IMPERIAL WAY behileote@kraftfoods.com <br /> CONTACT MAILING CITY 120 STATE 121171P COIR 122 <br /> STOCKTON CA 95215 <br /> IV. EMERGENCY CONTACTS <br /> NAME CLAY GIBSON 123 NAME MIKE HERNANDEZ 128 <br /> TITLE GENERAL MANAGER 124 TITLE SITE MANAGER 129 <br /> BUSINESS PHONE 209-942-0102X123 125 BUSINESS PHONE 209-942-0102-158 130 <br /> 24-HOIJRPHONE 209-403-0668 126 74-HOTTR PHONP 209-430-7498 131 <br /> PArFR/(FT.1.4 N/A 127 PAGPR/CM 1.4 N/A 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 /> SIGNATURE OF OWNER/OPERATOR OR DESIGNATED REPRESENTATIVE DATE 134 I NAME OF DOCUMENT PREPARER 135 <br />