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BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE Page 2 <br />MAILING ADDRESS (4 1) <br />If different from Site Address, <br />otherwise leave blank <br />NOTE: All official mail will <br />go to this address <br />BILLING ADDRESS (42) <br />If different from Mailing <br />Address, otherwise leave blank <br />TYPE OF <br />ORGANIZATION (43) <br />Is NENEbb MAILING AND BILLING INFORMATION <br />13851 FREEWAY BLVD <br />Street No. Direction Street Name Street Type <br />SACRAMENTO CA 195834 <br />CITY STATE ZIP <br />Street No. Direction Street Name Street T. pc <br />City State ZIP <br />ASSESSOR PARCEL NO. (45) <br />ADDITIONAL BUSINESS INFORMATION <br />❑ Single Owner ❑ Partnership UNSTAFFED SITE YES <br />® Corporation ❑ Public Agency NETWORK (44) <br />092-220-16 <br />PROPERTY OWNER (46) PHONE NO. (47) <br />NAME STOCKTON AUTO CENTER <br />(If different from Business Owner) <br />PROPERTY OWNER (48) <br />ADDRESS <br />3158 AUTO CENTER CIRCLE <br />Street Address <br />ISTOCKTON CA CA 9 -52 12 <br />City State ZIP <br />FIRE DISTRICT NO. 22 FIRE DISTRICT (49) <br />NAME ISTOCKTON <br />NEAREST CROSS (50) <br />STREET <br />HOLMAN RD & AUTO CENTER CIRCLE <br />FACILITY (51) NO IF YES, N/A <br />LOCK BOX WHERE IS IT LOCATED? (52) <br />NATURE OF BUSINESS (53) <br />TELECOMMUNICATIONS <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 />