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!on Business: KINGCA CERS ID79 <br />i N DE VRIES RD 101814 <br />CA 95240 <br />on 1/7/2015 by Gina Pimente/ of MCI, dba Verizon Business (Pomona, CA) <br />y <br />a <br />onfirmed/Updated Information <br />Verizon Business: KINGCA <br />13850 N DE VRIES RD <br />LODI, CA 95240 <br />Facility Type Board of Equalization Account Number <br />Other 44000966 <br />Is the facility located on Indian Reservation/Trust lands? <br />�- <br />No <br />N PACIFIC RAILROAD <br />271-2322 <br />DODGE ST <br />1A, NE 68179 <br />DBA VERIZON BUSINESS <br />1)620-5498 <br />S. Locust Street <br />ona, CA 91766 <br />DBA VERIZON BUSINESS v <br />,) 620-5498 <br />S. Locust Street <br />ona, CA 91766 <br />ank Owner Type <br />Non -Government <br />e��' t�oFd�er Mf�wrrna>�prt ` - <br />ermit Holder Notification information Supervisor of Division, Section, or Office (Required for Public Agencies Only) <br />ank Owner — :1_ <br />ndicate which approved mechanism(s) are being used to show financial responsibility either as contained in the federal regulations (40 CFR, Part 280, Subpart H, Sections 280.93 <br />180.107) or CCR, Title 23, Division 3, Chapter 18, Section 2808.1. <br />Self -Insured Surety Bond State Fund and CFO Letter Other Mechanism <br />Yes <br />"guarantee Letter of Credit State Fund and CD <br />nsurance Exemption Local Government Mechanism <br />fes <br />%pplicant Name Applicant Title Applicant Phone Date Certified <br />achary Feingold Environmental Management (909) 620-5498 9/17/2013 <br />Printed on 2/12/2015 3:52 PM <br />