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Bi,1SINESS OWNER/OPERATOR IDENTIFICATION FORM <br />6/18/2008 1[Account #: 12797 <br />I. IDENTIFICATION <br />BUSINESS NAME (4) AT&T NIOBILITY-HAMMER LN BUSINESS PHONE (5) <br />IWOS1 1800-832-6662 *2 <br />SITE ADDRESS (6) 13333 IF] FUTO CENTER CIR <br />Street No. Direction Street Name Street T e A tBld /Suite <br />CITY (7) ISTOCKTON STATE (8) CA ZIP (9) 95203 <br />DUN & (10) 10-202-6754 SIC CODE (4 DIGIT #) (11) 4812 <br />BRADSTREET <br />OPERATOR (12) AT&T MOBILITY OPERATOR PHONE (13) 916-285-4210 <br />NAME <br />II. BUSINESS OWNER <br />OWNER NAME (14) IDBAGULA & NEW BILIyINGULAR OWNER PHONE (15)AT&916-285-4210 <br />OWNER MAILING ADDRESS (16) 13851 N. FREEWAY BLVD. <br />(If different from site address) <br />CITY (17) SACRAMENTO STATE (18) CA ZIP (19) 95834 <br />III. ENVIRONMED <br />CONTACT NAME (20) 1EH&S - JESSICA NIELSEN <br />MAILING ADDRESS (22) <br />(If different from site address) 3851 N FREEWAY 11BLVD <br />AL CONTACT <br />CONTACT PHONE (2 1) 916-285-4210 <br />CITY (23) <br />3ireei Ivo. virecuon street iName <br />ACRAMENTO I <br />STATE (24) CA <br />street type a tits <br />ZIP (25) F ___ <br />Primary IV. EMERGENCY CONTACTS Secondary <br />NAME (26) ELLEN MAGNIE I I <br />NAME (3 1) GHIZAL ABAWI <br />TITLE (27) <br />MANAGER <br />BUSINESS PHONE (28)1510-305-2553 <br />24-HOUR PHONE (29) 1800-832-6662 *2 <br />PAGER # (30) 510-305-2553 <br />TITLE (32) <br />COMPLIANCE ANALYST II <br />BUSINESS PHONE (33) 1925-468-8553 <br />24-HOUR PHONE (34) 800-832-6662 *2 <br />PAGER # (35) 925-286-3207 <br />EXTREMELY HAZARDOUS SUBSTANCES (EHS) <br />ON-SITE EHS (36) YES If yes, and above Threshold Planning Quantities, attach a sheet of paper with a general <br />description of the process and principle equipment involved with the EHS. <br />ADDITIONAL LOCALLY COLLECTED INFORMATION (37) Provide information requested on the 2nd page of this form <br />NAME OF DOCUMENT PREPARER (38) <br />STANTEC CONSULTING INC. <br />NAME OF OWNER/OPERATOR (39) NEW CINGULAR WIRELESS DATE (40) <br />PCS, LLC DBA AT&T <br />