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UNIFIED PROGRAM CONSOLIDATED FORM <br /> FACILITY INFORMATION <br /> BUSINESS OWNER/OPERATOR IDENTIFICATION, PAGE 2 <br /> LOCALLY COLLECTED INFORMATION <br /> TYPE OF 138 1 NCTAFFFD CTTF.NETWORK 139 <br /> . .I. 1,. .T. El Single Owner ❑ Corporation ®Partnership <br /> NO <br /> ARSR9S0R PARCRI.N1 NMRR 140 NEAREST CROSS STREET 141 <br /> 14326009 FREMONT <br /> PROPERTY OWNER NAME(If different from Business Owner) 142 PHONE NO. 143 <br /> BILL ALAN 209-948-2704 <br /> PROPERTY OWNER STREET ADDRESS 144 PROPERTY OWNER CITY 145 STATE 146 ZIP CODE 147 <br /> 1550 SHAW RD STOCKTON CA 95215 <br /> FIRE DISTRICT NAME 148 FIRE DEPT NO. 14 FACILITY LOCK BOX 150 IF YES,WHERE IS IT LOCATED? 151 <br /> STOCKTON 612 NO N/A <br /> NA'R YR F.OF RT iRTNRRS 152 <br /> CHROME PLATING&METAL FINISHING <br /> WASTE GENERATOR 153 IF YES.ENTER EPA NUMBER 154 <br /> YES CAL000190430 <br /> TR ADF.RFCRFT TNFnRMATTON 155 SPILL PREVENTION AND COT TNTRRMEASURES PLAN PREPARED FOR FACILITY? 156 <br /> NO YES <br /> TRAINING PROGRAM INFORMATION 157 <br /> ...... .. : __ .: ,.. .: :.: , : : .._a..........,_ F YES <br /> Does your business maintain written training records that show the training subject,date(s)of training, NO <br /> ................ --a .,..a---..c:...........i,.w <br /> RTT LTNC ADDRFRR T£di££rrrnt£rnm M.M.. Addro ..nfh.rwi.n Inavc hlnnk <br /> BUSINESS BILLING ADDRESS 158 <br /> BUSINESS BILLING CITY 159 STATE I60 ZIP CODE 161 <br /> This area intentionally left blank <br />