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UNIFIED PROGRAM CONSOLIDATED FORM <br /> FACTT,ITV INFORMATION <br /> BUSINESS OWNER/OPERATOR IDENTIFICATION, PAGE 2 <br /> LOCALLY COLLECTED INFORMATION <br /> TYPE OF1381TNSTAFFFn STTF.WFTWnRK <br /> nT,n A*TT, ATTn*T ® Single Owner El Corporation ❑Partnership 139 <br /> NO <br /> ARRFRROR PAR(FT.WTTMRFR 140 NEAREST CROSS STREET 141 <br /> 261-020-10 FRONTAGE RD HWY 99 <br /> PROPERTY OWNER NAME(If different from Business Owner) 142 PHONE NO. 143 <br /> BOBI VALK 209-545-6051 <br /> PROPERTY OWNER STREET ADDRESS 144 PROPERTY OWNER CITY 145 STATE 146 ZIP CODE 147 <br /> 444 SISK RD MODESTO CA 95356 <br /> FIRE DISTRICT NAME 148 FIRE DEPT NO. 14 FACILITY LOCK BOX I S IF YES,WHERE IS IT LOCATED? 151 <br /> RIPON 1 NO <br /> WATT TRF OF RT TRTNFRR 152 <br /> TRUCK WASH <br /> WASTE GENERATOR 153 IF YES.ENTER EPA NUMBER 154 <br /> YES CAL001 <br /> TRAnF RFCRFT TNFORMATTON 155 SPILL PREVENTION AND COT TNTFRMEASURES PLAN PREPARED FOR FACILITY? 156 <br /> YES YES <br /> TRAINING PROGRAM INFORMATION 157 <br /> n...,.,......_ ....:........................._,...„..._..:..:__.._.,.__....L-. :--I..a....:-:9.., YES <br /> Does your business maintain written training records that show the training subject,date(s)of training, YES <br /> .._a_:,,..,,w. ,...o.,_..a......,.., <br /> --:--A _-a_---...,c:....._-----Tan <br /> RTLT.TN(_AnnRFRR If difrPrwn4 from Mnilina Addrrcc.nthwrwicr Innva hlnn4 <br /> BUSINESS BILLING ADDRESS 158 <br /> BUSINESS BILLING CITY 159 STATE 160 ZIP CODE 161 <br /> This area intentionally left blank <br />