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BUSINESS OWNER/OPERATOR IDENTIFICATION FORM Account#: 276 <br /> Primary Site#: 0 <br /> BEGINNING DATE(1) 2000 1. IDENTIFICATION DATE RECEIVED <br /> BUSINESS NAME (4) AUTOFIX OF STOCKTON BUSINESS PHONE(5) 209-474-1881 <br /> SITE ADDRESS (6) 7374 —IF URRAY DR <br /> Street No. Direction Street Name Street Type Apt/Bldg/Suite <br /> CITY (7) STOCKTON STATE(8)F- <br /> CA ZIP(9) 95210 <br /> DUN& (10) 130168719 SIC CODE(4 DIGIT#)(11) 7538 <br /> BRADSTREET <br /> OPERATOR (12) ROSS/SCOTT LENDER OPERATOR PHONE(13) 209-474-1881 <br /> NAME <br /> II. BUSINESS OWNER <br /> OWNER NAME(14) ROSS L LENDER & SCOTT A OWNER PHONE(15)1209-474-1881 <br /> LENDER <br /> OWNER MAILING ADDRESS(16) <br /> (If different from site address) <br /> CITY(17) STATE(18) ZIP(19) <br /> III. ENVIRONMENTAL CONTACT <br /> CONTACT NAME(20) ROSS L LENDER CONTACT PHONE(2 1) <br /> MAILING ADDRESS(22) <br /> (If different from site address) <br /> Street No. - Direction Street Name Street T e A )t/Bldg/Suite <br /> CITY(23) L -1 STATE(24) El ZIP(25) <br /> Primary IV. EMERGENCY CONTACTS Secondary <br /> NAME(26) ROSS L LENDER NAME(3 t> SCOTT A LENDER <br /> TITLE(27) OWNER TITLE(32) OWNER <br /> BUSINESS PHONE(28) 209-474-1881 BUSINESS PHONE(33) 209-474-1881 <br /> 24-HOUR PHONE(29) 209-951-7519 24-HOUR PHONE(34) 209-957-2285 <br /> PAGER#(30) N/A PAGER#(35) N/A <br /> EXTREMELY HAZARDOUS SUBSTANCES (EHS) <br /> ON-SITE EHS (36) NO If yes,and above Threshold Planning Quantities, attach a sheet of paper with a general <br /> description of the process and principle equipment. <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION(37) Provide information requested on the back of this form <br /> NAME OF DOCUMENT PREPARER(38) ROSS L LENDER <br /> NAME OF OWNERIOPERATOR(39) ROSS/SCOTT LENDER DATE(40) 1/8/1997 <br />