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BUSINESS OWNER/OI . TOR IDENTIFICATION FOI SIDE 2 <br /> BUSINESS MAILING AND BILLING INFORMATION <br /> MAILING ADDRESS(41) r <br /> (If different from Site Address) �� = � _ ,07/OV//-7'- <br /> NOTE: All time sensitive and Street No. Direction Street Name L Street Type <br /> official t correspondence ess will �/.l.�Zi25 <br /> be sent to this address l.��n C!, <br /> CITY STATE ZIP <br /> if / <br /> include"Care of information <br /> MAY 15 2001 <br /> C 01 ADDITIONAL BUSINESS INFORMATION <br /> TYPE OF ❑Single Owner ❑ Partnership UNSTAFFED SITE NETWORK(44) ❑YESNO <br /> ORGANIZATION (43) 10 Corporation ElPublic Agency <br /> ASSESSOR PARCEL NO. (45) <br /> PHONE N <br /> PROPERTY OWNER (46) / /j�� 'l/�� ).(47) �� ) <br /> NAME ]/ �/ OC �j �f rf72_ <br /> (If different from Business Owner) <br /> PROPERTY OWNER (48) /— <br /> ADDRESS � <br /> Street Address <br /> CITY STATE ZIP <br /> FIRE DISTRICT (49) <br /> NEAREST CROSS (50) <br /> STREET ��Q q C/&)J G <br /> FACILITY (51) IF YES. / <br /> LOCK BOX ❑YES �NO WHERE IS IT LOCATED'?(52) /�W <br /> NATURE OF BUSINESS (53) <br /> WASTE GENERATOR (54) IF YES, �8�3 -,11� <br /> YES ❑NO WHAT IS YOUR EPA NO.'?(55) �/ <br /> TRADE SECRET (56) SPILL PREVENTION (57) <br /> INFORMATION /LSD /U N AND COUNTERMEASURES <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 ❑NO <br /> Does your business maintain written training records that show the training subject,date(s)of training. (59)� <br /> names and signatures of employees trained,and names of instructor(s)? �'YES ❑NO <br /> 12/00 <br />