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BUSINESS OWNER/OPERA'1`OR IDENTIFICATION PAGE Page 2 <br /> BUSINESS MAILING AND BILLING INFORMATION <br /> MAILING ADDRESS(41) P.O. BOX 711-GASOLINE <br /> If different from Site Address, ACCTG <br /> otherwise leave blank Street No. Direction Street Name Street Type <br /> NOTE: All official mail <br /> will go to this address DALLAS TX 75221-0711 <br /> City State ZIP <br /> BILLING ADDRESS (42) JP.O. BOX 711-GASOLINE <br /> If different from Mailing ACCTG <br /> Address,otherwise leave blank Street No. Direction Street Name Street Type <br /> DALLAS' TX 75221-0711 <br /> City 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) <br /> 110-020-03 <br /> PROPERTY OWNER (46) 7-ELEVEN INC ATTN GASOLINE PHONE NO. (47) <br /> NAME ACCTG 253-796-7170 <br /> (If different from Business Owner) <br /> PROPERTY OWNER . (48) <br /> ADDRESS P.O BOX 711 <br /> Street Address <br /> DALLAS 1TX 1175221-0711 <br /> CITY STATE ZIP <br /> FIRE DISTRICT NO. 405H FIRE DISTRICT (49) <br /> NAME STOCKTON FD <br /> NEAREST CROSS (50) <br /> STREET MARCH LN <br /> t <br /> FACILITY (51) NO IF YES, <br /> LOCK BOX I I WHERE IS IT LOCATED?(52) <br /> NATURE OF BUSINESS (53) RETAIL PETROLEUM/FOOD STORE <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 NO <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: 8/15/06 <br />