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BUSINF)SS IDENTIFICATION FORM Page3 of4 <br /> ADDITIONAL BUSINESS INFORMATION <br /> TYPE OF Single Owner Corporation Partnership Publicr4p�liilEIVED <br /> ORGANIZATION (43 --- OM <br /> MAIR 20 <br /> UNSTAFFED SITE L 1 iN <br /> NETWORK (44) OFFICE OFENEERGENCYSERVI EE <br /> ASSESSOR PARCEL NO. (45) <br /> PROPERTY OWNER PHONE NO. (47) IF 921 -is�3 <br /> NAME (46) <br /> PROPERTY OWNER F77s' $6Cyy-5 b 5r <br /> ADDRESS (48) <br /> STREET ADDRESS <br /> �- <br /> CI7y STATE ZIP <br /> FIRE DISTRICT (49) FIRE DISTRICT <br /> NEAREST CROSSI�-$ ST <br /> STREET (50) <br /> FACILITY IF YES, <br /> LOCK BOX (51) WHERE IS IT LOCATED? (52) <br /> NATURE OF <br /> BUSINESS (53) <br /> WASTE GENERATOR (54) 66 01 IF YES, <br /> WHAT IS YOUR EPA NO.? (55) <br /> TRADE SECRET . SPILL PREVENTION <br /> INFORMATION (56) AND COUNTERMEASURES <br /> PLAN FOR THIS FACILITY (57) <br /> TRAINING PROGRAM INFORMATION <br /> DOES YOUR BUSINESS HAVE AN EMPLOYEE TRAINING PROGRAM THAT INCLUDES . <br /> INITIAL TRAINING AND ANNUAL REFRESHERS? (58) <br /> DOES YOUR BUSINESS MAINTAIN WRITTEN TRAINING RECORDS THAT SHOW THE <br /> TRAINING SUBJECT DATE(S) OF TRAINING NAMES AND SIGNITURES OF EMPLOYEES ` <br /> TRAINED AND NAMES OF INSTRUCTOR(S)? (59) <br /> Submit Changes <br /> http://www.sjoesdata.orglaction.lasso?-Database=oes_login&-layout=html&-response=chmirf update.la... 3/12/2007 <br />