Laserfiche WebLink
UNIFIED PROGRAM CONSOLIDATED FORM <br /> FACITdTV INFORMATION <br /> BUSINESS OWNER/OPERATOR IDENTIFICATION, PAGE 2 <br /> LOCALLY COLLECTED INFORMATION <br /> TYPE OF ❑ Partnershl 13 I TNSTAFFFOSTTF.NF.TWORK 139 <br /> ❑Single Owner ❑ Corporation P <br /> nen A NIT A mT~ <br /> 141 <br /> ASSFSSf1R PARCFT.NITMRFR 140 NEAREST CROSS STREET <br /> 142 PHONE NO. 143 <br /> PROPERTY OWNER NAME(If different from Business Owner) 209-369-9126 <br /> LODI AIRPORT <br /> PROPERTY OWNER STREET ADDRESS ,,1144 PROPERTY OWNER CITY 145 STATE 146 ZIP CODE 147 <br /> FIRE DISTRICT NAME 14 FIRE DEPT NO. 14 FACILITY FACILITY LOCK BOX 1511F YES,WHERE IS IT LOCATED? 15 I <br /> WOODBRIDGE 7 <br /> 152 <br /> N ATT EOFMF.SSWASTTOR153 IF YES.ENTER EPA NUMBER 154 <br /> TR AT)F.SF.(.RFT INFORMATION 155 SPILL PREVENTION AND COTINTF.RMEASURES PLAN PREPARED FOR FACILITY? 156 <br /> NO <br /> TRAINING PROGRAM INFORMATION 157 <br /> ti..:..:....__...._......I....:....L.A....:_:.:..I r..:_:_...._A.._......1_..Q....L..._..O NO <br /> Does your business maintain written training records that show the training subject,date(s)of training, <br /> NO <br /> .._A..:......w. ..C....._1..........--:--A .._d_......._-f:_—...b._"" <br /> RTI.I INC ArIT1RFCS Ifdiffrrrnf from Mailino Addrocc nihrrwicr Inaw hlank <br /> 158 <br /> BUSINESS BILLING ADDRESS <br /> BUSINESS BILLING CITY <br /> 159 STATE 160 ZIP CODE 161 <br /> This area intentionally left blank <br />