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ANk <br /> BUSINESS OWNER/OPERA OR IDENTIFICATION PAGE Page 2 <br /> BUSINESS MAILING AND BILLING INFORMATION <br /> MAILING ADDRESS(41) 5948 WATERLOO RD <br /> If different from Site Address, F11 <br /> otherwise leave blank Street No. Direction Street Name Street Type <br /> NOTE:All official mail STOCKTON CA 95215 <br /> will go to this address <br /> City State ZIP <br /> BILLING ADDRESS(42) <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) 17451015004 <br /> PROPERTY OWNER (46) TOM MARAGLIANO PHONE NO. (47) 209-463-2641 <br /> NAME <br /> (If different from Business Owner) <br /> PROPERTY OWNER (48) <br /> ADDRESS 1775 W. 2ND STREET <br /> Street Address <br /> STOCKTON CA 95206 <br /> CITY STATE ZIP <br /> FIRE DISTRICT NO. STAT FIRE DISTRICT (49) ISTOCKTON CA <br /> ION 1 NAME <br /> NEAREST CROSS (50) <br /> FSTOCKTONSTREET STREET <br /> FACILITY (51) NO IF YES, N/A <br /> LOCK BOX D WHERE IS IT LOCATED?(52) <br /> NATURE OF BUSINESS (53) EXCAVATING <br /> WASTE GENERATOR (54) NO [F 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: 5/3/0 7 <br />