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SEP 1 6 2001 <br /> BUSINESS OWNER/OPER*fOR IDENTIFICATION PAGE s Page 2 <br /> BUSINESS MAILING AND BILLING INFORMATION <br /> MAILING ADDRESS(41) = O.BOX 1410 <br /> If different from Site Address, <br /> otherwise leave blank Street No. Direction Street Name Street Type <br /> NOTE:All official mail STOCKTON CA 95201 <br /> will go to this address <br /> City State ZIP <br /> BILLING ADDRESS(42) �� <br /> If different from Mailing <br /> Address,otherwise leave blank Street No. Direction Street Name Street Type <br /> Citv State ZIP <br /> ADDITIONAL BUSINESS INFORMATION <br /> TYPE OF ❑Single Owner ❑Partnership UNSTAFFED SITE NO <br /> ORGANIZATION(43) ®Corporation ❑Public Agency NETWORK(44) <br /> ASSESSOR PARCEL NO. (45) 162-03-02 <br /> PROPERTY OWNER (46) PHONE NO. (47) <br /> NAME PORT OF STOCKTON 209-946-0246 <br /> (If different from Business Owner) <br /> PROPERTY OWNER (48) <br /> ADDRESS 2201 WEST WASHINGTON STREET <br /> Street Address <br /> STOCKTON CA 95203 <br /> CITY STATE ZIP <br /> FIRE DISTRICT NO. EN FIRE DISTRICT (49) <br /> G NAME STOCKTON FIRE DEPT <br /> NEAREST CROSS (50) <br /> F <br /> STREET LLSBERG <br /> FACILITY (51) NO IF YES, N/A <br /> LOCK BOX WHERE IS IT LOCATED?(52) <br /> NATURE OF BUSINESS (53) <br /> WAREHOUSING <br /> WASTE GENERATOR (54) NO IF YES, <br /> WHAT IS YOUR EPA NO.?(55) N/A <br /> TRADE SECRET (56) SPILL PREVENTION (57) <br /> INFORMATION NO AND COUNTERMEASURES YES <br /> PLAN FOR THIS FACILITY <br /> TRAINING PROGRAM INFORMATION <br /> Does your business have an employee training program that includes initial training and annual refreshers? (58) YES <br /> Does your business maintain written training records that show the training subject,date(s)of training, (59) YES <br /> names and signatures of employees trained,and names of instructor(s)? <br /> DATE REC'D: 9/16/03 <br />