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BUSINESS OWNER/OPERATOR IDENTIFICATION FORM <br />6/18/2008 11 Account #: 12779 <br />I. IDENTIFICATION <br />BUSINESS NAME (4) AT&T MOBILITY -WATERLOO::] BUSINESS PHONE (5) 1800-832-6662 *2 <br />SITE ADDRESS (6) 17333 IFIIJACK TONE E=1 <br />Street No. Direction Street Name Street T e Apt/Bldg/Suite <br />CITY (7) ISTOCKTON STATE (8) CA ZIP (9) 95201 <br />DUN & (10) 10-202-6754 SIC CODE (4 DIGIT #) (11) 4812 <br />BRADSTREET <br />OPERATOR (12) AT&T MOBILITY OPERATOR PHONE (13) <br />NAME 916-285-4201 <br />II. BUSINESS OWNER <br />OWNER NAME (14) CINGULAR & NEW CINGULAR I OWNER PHONE (15) 916-285-4201 <br />DBA AT&T MOBILITY <br />OWNER MAILING ADDRESS (16) 3851 N. FREEWAY BLVD. <br />(If different from site address) <br />CITY (17) SACRAMENTO STATE (18) CA ZIP (19) 95834 <br />III. ENVIRONMEP <br />CONTACT NAME (20) 1EH&S - JESSICA NIELSEN <br />MAILING ADDRESS (22) <br />(If different from site address) 3851 N FREEWAY BLVD <br />Street No. <br />AL CONTACT <br />CONTACT PHONE (2 1) 1916-285-4201 <br />CITY (23) <br />NAME (26) IELLEN MAGNIE <br />Direction Street Name Street <br />STATE (24) C A:1 ZIP (25) E51 <br />IV. EMERGENCY CONTACTS Secondz <br />NAME (3 1) <br />GHIZAL ABAWI <br />TITLE (27) (COMPLIANCE MANAGER <br />BUSINESS PHONE (28) 510-305-2553 <br />24-HOUR PHONE (29) 1800-832-6662 *2 <br />PAGER # (30) <br />TITLE (32) (COMPLIANCE ANALYST H <br />BUSINESS PHONE (33) 925-468-8553 <br />24-HOUR PHONE (34) <br />8(1(1-832-6662 *2 <br />PAGER # (35) 1925-286-3207 <br />EXTREMELY HAZARDOUS SUBSTANCES (EHS) <br />ON-SITE EHS (36) YES I If yes, and above Threshold Planning Quantities, attach a sheet of paper with a general <br />description of the process and principle equipment involved with the EHS. <br />ADDITIONAL LOCALLY COLLECTED INFORMATION (37) Provide information requested on the 2nd page of this form <br />NAME OF DOCUMENT PREPARER (38) ISTANTEC CONSULTING INC. <br />NAME OF OWNER/OPERATOR (39) NEW CINGULAR WIRELESS DATE (40) <br />PCS, LLC DBA AT&T <br />