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VIED PROGRAM CONSOLIDATED <br /> FACIIdTY INFORMATION <br /> BUSINESS OWNER/OPERATOR IDENTIFICATION <br /> I.IDENTIFICATION <br /> FACILI I T ID# 1 BEGINNING DATE loo ENDING DATE I01 <br /> F 1010101 5 0 8 4 <br /> BUSINESS NAME(sere ee FAcmny NAw or DBA-DoingB..Aa) fl5-1 05-18-103 <br /> BUSINESS PHONE Im <br /> CEMEX Construction Materials Pacific LLC 209-982-0555 <br /> BUSINESS SITE ADDRESS 103 BUSINESS FAX IOU <br /> 889 East Roth Road 209-983-0012 <br /> BUSINESS SITE CITY IN ZIP CODE Ios COUNTY lae <br /> CA 1 <br /> DUN&BRADSTREET los PRIMARY SIC 109 PRIMARY NAICS 10. <br /> 18-984-0945 3273 <br /> BUSINESS MAILING ADDRESS <br /> 5180 Golden Foothill Pal10 <br /> BUSINESS MAILING CITY Ions STATE loss ZIP CODE loss <br /> El Dorado Hills CA 95762 <br /> BUSINESS OPERATOR NAME l09 BUSINESS OPERATOR PHONE Do <br /> IL BUSINESS OWNER <br /> OWNER NAME 111 OWNER PHONE 112 <br /> CEMEX—Ati Louis B. Schipper 916-941-2920 <br /> OWNER MAILING ADDRESS <br /> 5180 Golden Foothill Parkway <br /> 113 <br /> OWNER MAILING CITY 11e STATE IIsI Z10 CODE us <br /> El Dorado Hills CA 95762 <br /> III.ENVIRONMENTAL CONTACT <br /> CONTACTNAME 117 CONTACTpHONE IIs <br /> Louis B. Schimer 9 916-941-2920 <br /> CONTACT MAILING ADDRESS CONTACT EMAIL 119. <br /> 5180 Golden Foothill Pazkwa l '. mi .aii <br /> CONTACT MAILING CITY Ito STATE 121 Z�CODE Izz <br /> El Dorado Hills CA 95762 <br /> -PRIMARY- IV.EMERGENCY CONTACTS -SECONDARY- <br /> NAME Im NAME <br /> 128 <br /> Steve Holland H Ambrosini <br /> TITLE <br /> 129 TITLE <br /> 129 <br /> Area Manager rations Mana er <br /> BUSINESS PHONE I25 BUSINESS PHONE 130 <br /> 2-HOURPHONE 559-277-2266 xt. 107 <br /> 24-HOUR PHONE 126 24-HOUR PHONE 131 <br /> 209-652-3968 59-217-8626 <br /> PAGER# <br /> 127 PAGER# 132 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: 133 <br /> Certification. Based on my inquiry of those individuals responsible for obtaining the is t <br /> the information id ti n,[certify under penalty of law that[have personally exnmined and <br /> am familiar with ormation submiaed and believe the infomlation rue,aceulate,e,anand complete. <br /> SIGNATURE OF O 11tA ORD ATEDRF$RHS ATIVE DATE t3a NAME OF DOCUMENT'PREPARIIt 135 <br /> t <br /> NAME OF SIGNER 05/18/09 Michelle K. Wesch <br /> (prim) 136 TITLE OF SIGNER <br /> 3] <br /> Michelle K. Wesch Environmental Assistant <br /> UPCF(Rev.12/1 <br />