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AM <br /> BUSINESS OWNER/OPERATOR IDENTIFICATION FORM SIDE i 2001 <br /> BEGINNING DATE(1) 1/1/00 I. IDENTIFICATION PAGE I OFL—� <br /> BUSINESS NAME (4) BUS INEANOU(5) <br /> Red Lobster (1381 209�/473-2420 <br /> IJ <br /> SITE ADDRESS (6) 2283�❑ <br /> W March Lane <br /> Street No. Direction Street Name Street T e A t/Qld /Suite <br /> CITY (7) STATE(8) ZIP(9) <br /> Stockton I CA 95207 <br /> DUN& (I(l) X5.11/0 SSM SIC CODE(4DIGIT#)(II) <br /> BRADSTREET 5812 <br /> OPERATOR (12) OPERATOR PHONE(13) <br /> NAME _Joe Klinzing, General gr. <br /> II. BUSINESS OWNER <br /> OWNERNAME(14) OWNER PHONE(15) �I <br /> GMRI, Inc. 407/245-5398 <br /> OWNER ADDRESS (16) P. 0. Box 593330 <br /> (If different from Entries#6 or#41) <br /> CITY(17) FL <br /> STATE(18) � ZIP(19) <br /> Orlando 32859-3330 <br /> III. ENVIRONMENTAL CONTACT <br /> CONTACT NAMEt/�I Al �� CONTACT PHONE(;'I4 g _ SyS-310- <br /> Fio'e-CONTACT ADDRESS ( 6) j ❑ ��� <br /> (If different from Entries#6 <br /> or#41) Street No. Direction Street Name Street T e A t/Bldg/Suite <br /> CITY(23) STATE(24) ZIP(25) <br /> Primary IV. EMERGENCY CONTACTS Secondary <br /> NAME(26) NAME(3 1) <br /> Joe Klinzing Mark Rutledge <br /> TITLE(27) ETITLE(32) <br /> General Manager Assistant Manager <br /> BUSINESS PHONE(28) 209/473-2420 BUSINESS PHONE(33) 209/473-2420 <br /> 24-HOUR PHONE(29) 24-HOUR PHONE(34) <br /> (After Business Hours) 209/545-3148 (After BusinessHour s) 209/941-9731 <br /> PAGER#(30) PAGER#(35) 209/648-1004 <br /> Cell 209/480-1999 <br /> EXTREMELY HAZARDOUS SUBSTANCES (EHS) <br /> ON-SITE EHS (36) 1 []YES 0 NO If yes,and above Threshold Quantities,attach a sheet of paper with a general <br /> description of the process and principle equipment. <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION(37) Provide information requested on the back of this form <br /> NAME OF DOCUMENT PRF.PARER(38) <br /> Kathy Shaver, License Administrator <br /> NAME OF OWNER/OPERATOR(39) DATE(40) 1/10/O1 <br /> GMRI, Inc. <br /> SJC 12/00 <br />