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r <br /> *"eNIFIED PROGRAM CONSOLIDATED F6WM <br /> FACTUTTV INFnRMATInN <br /> BUSINESS OWNER/OPERATOR IDENTIFICATION <br /> Last Website Update: Page of <br /> L IDENTIFICATION <br /> FAC'TT 3TY TT7# 13907 1 RF.(,TNNINC,DATE N/A 100 ENDING DATE N/A 101 <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doine Business Asl 3 BUSINESS PHONE 102 <br /> ROCKITE CO 209-46274404 <br /> RITSTNFSS S1TF. AnnRF.SS 103 BUSINESS FAX <br /> 1550 SHAW RD #D Not Collected <br /> BUSINESS SITE CITY 104 7.1P CODE 105 COUNTY 108 <br /> STOCKTON I CA 95215 SAN.IOAOUIN <br /> DUN&BRADSTREET 106 PRIMARY SIC 107 PRIMARY NAICS 10,7,q <br /> 4525655 N/A Not Collected <br /> RI NWRSS MATT.TNC AnnRF.SC 100 <br /> BUSINESS MAILING CITY 109t STATE d OR ZIP CODE 108d <br /> BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR P14ONE 110 <br /> NEIL DAVIS 209-918-0815 <br /> 11. BUSINESS OWNER <br /> OWNER NAME(14) 111 1 OWNER PHON .t 51 112 <br /> NEIL DAVIS 209-918-0815 <br /> OWNER MATTING AnnRF.ss 113 <br /> 4212 ELDENBERRY CT <br /> OWNRR MATT.TNG CITY 114 STATE 115 7TP MnF. 116 <br /> MODESTO CA. 95356 <br /> I11. ENVIRONMENTAL CONTACT <br /> CONTACT NAME 117 1 CONTACT PHONE 118 <br /> NEIL DAVIS 209-918-0815 <br /> CONTACT MAILING ADDRESS 1 1° CONTACT EMAIL 119 <br /> neilhdavis@sbcglobal.net <br /> CONTACT MAILING CITY 120 STATE 121 71P CODF. 122 <br /> IV. EMERGENCY CONTACTS <br /> NAME NEIL DAVIS 123 NAME BILL ALLEN 128 <br /> TITLE 129 <br /> OWNER 124 TITLE PROPERTY OWNER <br /> BUSINESS PHONE 209_462-4404 125 BUSINESS PHONE 209-948-2704 130 <br /> 24-HOUR PHONE 209-918-0815 126 M-N011R PHnNF. 209-481=8436 131 <br /> PAC:FR/CFT.T.il N/A 127 PAGF.R/CF.T.L,# 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,1 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 fainiliar with the informaiton submitted and <br /> SIGNATURE OF OWNER/OPERATOR OR DESIGNATED REPRESENTATIVE DATE 134 NAME OF DOCUMENT PREPARER 135 <br /> i <br />