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BUSINESS OWNER/OPERATOR IDENTIFICATION FORM <br />1/25/2008 11 Account #: 1278 <br />I. IDENTIFICATION <br />BUSINESS NAME (4) AT&T MOBILITY -WEBER BUSINESS PHONE (5) �800-832-6662 'I`2 <br />SITE ADDRESS (6) 306 E❑ MAIN ST <br />Street No. Direction Street Name Street T e Apt/Bldg/Suite <br />CITY (7) ISTOCKTON STATE (8) CA ZIP (9) 95201 <br />DUN & (10) 10-202-6754 SIC CODE (4 DIGIT #) (1 l) 4812 <br />BRADSTREET <br />OPERATOR (12) AT&T MOBILITY OPERATOR PHONE (13) 916-285-4201 <br />NAME <br />H. BUSINESS OWNER <br />OWNER NAME (14) CINGULAR & NEW CINGULAR I OWNER PHONE (15) 916-285-4201 <br />DBA AT&T MOBILITY <br />OWNER MAILING ADDRESS (16) 3851 N. FREEWAY BLVD. <br />(If different from site address) <br />CITY (17) Q A !`DA 11A -V ►TTl1 STATE (l8) �� ZIP (19) <br />CONTACT NAME (20) IEH&S - JESSICA NIELSEN <br />MAILING ADDRESS (22) <br />(If different from site address) 3851 N FREEWAY BLVD <br />CONTACT PHONE (2 1) [916-285-4201 <br />Street No. Direction Street Name <br />CITY (23) SACRAMENTO STATE (24) CA <br />Street 11,ype A t/Bld /Sufic <br />ZIP (25) ____ . <br />Primary IV. EMERGENCY CONTACTS Secondary <br />NAME (26) NAME (3 1) <br />ELLEN MAGNIE GHIZAL ABAWI <br />TITLE (27) TITLE (32) <br />COMPLIANCE MANAGER COMPLIANCE ANALYST H <br />BUSINESS PHONE (28) <br />24-HOUR PHONE (29) 1800-832-6662 *2 <br />PAGER # (30) 510-305-2553 <br />BUSINESS PHONE (33) <br />24-HOUR PHONE (34) 1800-832-6662 *2 <br />PAGER # (35) 1925-286-3207 <br />EXTREMELY HAZARDOUS SUBSTANCES (EHS) <br />ON-SITE EHS (36) YES IIf 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) ISTANTEC CONSULTING INC. <br />NAME OF OWNER/OPERATOR (39) NEW CINGULAR WIRELESS DATE (40) <br />PCS, LLC DBA AT&T <br />