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VIII. PRIORITY CLASS DESIGNATION Continued from Pa r 4 B. IF CLAIMING CLASS B — SMALL BUSINESS,CHECK THIS BOX AND COMPLETE THE FOLLOWING: B, BUSINESS NAME BUSINESS DESCRIPTION DATES OF BUSINESS OPERATIONS FROM: TO. i PRINCIPAL BUSINESS ADORESS 193 IS THE PRINCIPAL OFFICE LOCATED IN CALIFORNIA? ❑YES ❑NO - ARE ALL OFFICERS OF THIS BUSINESS OOMICLEO IN CALIFORNIA? ❑ YES ❑ NO IS THIS BUSINESS INDEPENDENTLY OWNED AND OPERATED? ❑ YES ❑ NO IS THIS BUSINESS DOMINANT STATEWIDE IN ITS FIELD OF OPERATION? ❑ YES ❑ NO I 97.TYPE OF BUSINESS INDUSTRY GROUPI MAXIMUM RECEIPTS AMC ❑I SERVICE ❑ CONSTRUCTION ❑ MANUFACTURER ❑ NON-MANUFACTUREA LICENSE i'/PE s BA.TYPE OF OWNERSHIP IJ SOLE PROPRIETOR ❑ PARTNERSHIP ❑ CORPOMT10N ❑ OTHER-PNN SDmc1Y. BS.AFFILIATED COMPANIES NAME: LOCATION: RELATIONSHIP: I 90.ANNUAL RECEIPTS FOR THREE FISCAL YEARS PER INSTRUCTIONS. s + s + s = s 19_ IO_ ,G_ TOTAL NOTE: REFER TO APPLICATION INSTRUCTIONS FOR REQUIRED DOCUMENTATION TO SUPPORT THE ABOVE CLAIMED Fill STATEMENT. THIS DOCUMENTATION MUST BE SUBMITTED AT THE TIME OF APPLICATION. C. U IF CLAIMING CLASS C — OTHER BUSINESS CHECK THIS BOX AND COMPLETE THE FOLLOWING: Cl BUSINESS NAME BUSINESS DESCRIPTION OATES OF BUSINESS OPERATIONS FROM TO PRINCIPAL BUSINESS ADDRESS C2 N0.OF EMPLOYEES THE PRINCIPAL OFFICE LOCATED IN CALFORNIAI ❑YES ❑NO ARE ALL OFFICERS OF THIS BUSINESS DOMICILED IN CALFORNIA7 ❑ YES ❑ NO IS THIS BUSINESS INDEPENDENTLY OWNED AND OPERATED? ❑ YES ❑ NO IS THIS BUSINESS DOMINANT STATEWIDE IN ITS FEED OF OPERATION? ❑ YES ❑ NO G.TYPE OF OWNERSHIP ❑ SOLE PROPRIETOR ❑ PAATNEASHF ❑ CORPORATION ❑ OTHER—Pw.Sweily Ci AFFILIATED COMPANIES NAME: LOCATION: RELATIONSHIP: i II NOTE: REFER TO APPLICATION INSTRUCTIONS FOR REQUIRED DOCUMENTATION TO SUPPORT THE ABOVE CLAIMED STATEMENT. THIS DOCUMENTATION MUST BE SUBMITTED AT THE TIME OF APPLICATION. 0. IF CLAIMING CLASS D — ALL OTHER TANK OWNERS/OPERATORS CHECK THIS BOX. NO FURTHER PRIORI CLASS INFORMATION IS REQUIRED.