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BUSINESS OWNER/OPERATOR IDENTIFICATION PA E SIDE 2 <br /> BUSINESS MAILING AND BILLING INFORMATION <br /> MAILING ADDRESS Address <br /> �� F rStre� <br /> If different from Site Address Street No. Direction e Street Type <br /> _ Gy <br /> ZIP <br /> NOV 1 2 1997 '� STATE / �KS <br /> CITY BILLING ADDRESS (42) / <br /> If different from above; <br /> include"Care of information <br /> ADDITIONAL BUSINESS INFORMATION <br /> TYPE OF UNMANNED SITE NETWORK(44) �yES <br /> ORGANIZATION(43) :); Qall_lz Ay <br /> BUSINESS LICENSE NO. (45) EXPIRATION DATE(46) <br /> ASSESSOR PARCEL NO. (47) <br /> PROPERTY OWNER (48) PHONE NO. (49) <br /> NAME <br /> (If different from Business Owner) <br /> PROPERTY OWNER (50) <br /> ADDRESS 7 <br /> i <br /> Street Address <br /> CITY STATE ZIP <br /> FIRE DISTRICT (51) <br /> NEAREST CROSS (52) <br /> STREET Qf <br /> FACILITY (53) YES, <br /> LOCK BOX EYES WHERE IS IT LOCATED?(54) <br /> NATURE OF BUSINESS (55) <br /> WASTE GENERATOR (56) IF YES, <br /> ES []N WHAT IS YOUR EPA NO.?(57) <br /> TRAINING PROGRAM INFORMATION <br /> Does your business have an employee training program that includes initial training and annual refreshers? (58) �yES <br /> ,t4a _e�? 916 yl4s <br /> Does your business maintain written training records that show the training subject,date(s)of training, (59) ❑yES �NO <br /> names and signatures of employees trained,and names of instructor(s)? <br /> SIC 12/96 <br />