Laserfiche WebLink
BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE Page 2 <br /> BUSINESS MAILING AND BILLING INFORMATION <br /> MAILING ADDRESS(41) 1675 CHARTER WAY <br /> If different from Site Address, <br /> otherwise leave blank Street No. Direction Street Name Street Type <br /> NOTE: All official mail STOCKTON CA 95206 <br /> will go to this address <br /> City State ZIP <br /> BILLING ADDRESS(42) �F <br /> If different from Mailing <br /> Address,otherwise leave blank Street No. Direction Street Name Street Type <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) TBD <br /> PROPERTY OWNER (46) PHONE NO. (47) <br /> M&M DITCHING 209-931-1043 <br /> NAME <br /> (If different from Business Owner) <br /> PROPERTY OWNER (48) <br /> 1775ADDRESS SECOND ST <br /> Street Address <br /> STOCKTON CA 95206 <br /> CITY STATE ZIP <br /> FIRE DISTRICT NO. 22 FIRE DISTRICT (49) <br /> NAME ISTOCKTON <br /> NEAREST CROSS (50) <br /> FSTOCKTONSTREET ST <br /> FACILITY (51) NO IF YES, <br /> LOCK BOX WHERE IS IT LOCATED?(52) <br /> NATURE OF BUSINESS (53) TRUCK STORAGE YARD <br /> WASTE GENERATOR (54) YES IF YES, <br /> WHAT IS YOUR EPA NO.?(55) CAL000236223 <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: 5/11/07 <br />