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BUSINESS OWNER/OPLVATOR IDENTIFICATION FOR ICI• SIDE 2 <br /> BUSINESS MAILING AND BILLING ..INFORMATION <br /> MAILING ADDRESS(41) �`-r)--I- r •-� 4 9 S j <br /> (If different from Site Address) 22 5� t)I CYViQ rQ l <br /> NOTE: All time sensitive and Street No. Direction Street Name Street Type <br /> official correspondence will CA 95205 <br /> be sent to this address cS( CCKT0,AJ <br /> CITY STATE ZIP <br /> BILLING ADDRESS(42) 'JAN 17001 <br /> If different from above, <br /> include"Care of information <br /> ADDITIONAL BUSINESS INFORMATION <br /> TYPE OF Single Owner ❑Partnership UNSTAFFED SITE NETWORK(44) yES �NO <br /> ORGANIZATION (43) ❑Corporation ❑Public Agency <br /> ASSESSOR PARCEL NO. (45) I c7 0OVn <br /> p <br /> -1 2o2 <br /> PROPERTY OWNER (46) PHONE NO. (47) <br /> NAME 5TH E SNEEZY <C D�' � •�{�£ <br /> (If different from Business Owner) <br /> PROPERTY OWNER (48) <br /> ADDRESS 2,2SC c5-rE1\bAK?r 57— <br /> Street Address <br /> Sig ck7on� I �' I 9sac5 <br /> CITY STATE ZIP <br /> FIRE DISTRICT (49) <br /> NEAREST CROSS (50) <br /> STREET ,SA^6 L11/fE TT 1 Z'44E <br /> FACILITY (51) ❑YES �NO IF YES, <br /> LOCK BOX WHERE IS IT LOCATED?(52)1 <br /> NATURE OF BUSINESS (53) P1,570-&r/Z,e C UNC GC�(7dN� U�LI� `FLk3�iCA�CN <br /> C G f PI PC <br /> WASTE GENERATOR (54) IF YES. <br /> ❑YES �NO WHAT IS YOUR EPA NO.?(55) <br /> TRADE SECRET (56) ��SPILL PREVENTION (57) <br /> INFORMATION AND COUNTERMEASURES <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 ❑NO <br /> Does your business maintain written training records that show the training subject,date(s)of training, (59) ❑ <br /> names and signatures of employees trained,and names of instructor(s)? YES NO <br /> 12/00 <br />