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AhL AM <br /> BUSINESS OWNER/OPERA R IDENTIFICATION PAGE Page 2 <br /> BUSINESS MAILING AND BILLING INFORMATION <br /> MAILING ADDRESS ) <br /> If different from SiteteAddress, <br /> otherwise leave blank Street No. Direction Street Name Street Type <br /> NOTE:All official mail <br /> will go to this address <br /> City State ZIP <br /> BILLING ADDRESS ) �� <br /> If different from Mailing ailing <br /> Address,otherwise leave blank Street No. Direction Street Name Street Type <br /> City State ZIP <br /> ADDITIONAL BUSINESS INFORMATION <br /> TYPE OF ®Single Owner ❑Partnership UNSTAFFED SITE YES <br /> ORGANIZATION(43) ❑Corporation ❑Public Agency NETWORK(44) <br /> ASSESSOR PARCEL NO. (45) <br /> 1257-097-09 <br /> PROPERTY OWNER (46) PHONE NO.(47) <br /> NAME GEORGE TURKANY 209-823-8434 <br /> (If different from Business Owner) <br /> PROPERTY OWNER (48) <br /> ADDRESS 131021 TWO RIVERS RD. <br /> Street Address <br /> IMANTECA CA 95337-9468 <br /> CITY STATE ZIP <br /> FIRE DISTRICT NO. Fm—?FN1 FIRE DISTRICT (49) <br /> NAME IMANTECA/LATHROP <br /> TECA <br /> NEAREST CROSS (50) DIVISION RD. <br /> STREET <br /> FACILITY (51) NO IF YES, <br /> LOCK BOX WHERE IS IT LOCATED?(52) <br /> NATURE OF BUSINESS (53) BOAT LAUNCH & R.V. PARK <br /> WASTE GENERATOR (54) NO IF YES, <br /> WHAT IS YOUR EPA NO.?(55) N/A <br /> TRADE SECRET (56) SPILL PREVENTION (57) <br /> INFORMATION NO AND COUNTERMEASURES NO <br /> PLAN FOR THIS FACILITY <br /> TRAINING PROGRAM INFORMATION <br /> Does your business have an employee training program that includes initial training and annual refreshers? (58) YES <br /> Does your business maintain written training records that show the training subject,date(s)of training, (59) YES <br /> names and signatures of employees trained,and names of instructor(s)? <br /> DATE REC'D: 3/10/04 <br />