Laserfiche WebLink
BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE Page 2 <br /> BUSINESS MAILING AND BILLING INFORMATION <br /> If difffeferenntt from Site Addreess,rADDRESS(a1210 F VERA AVE <br /> otherwise leave blank Street No. Direction Street Name Street Type <br /> NOTE: All official mail RIPON CA 95366 <br /> will go to this address <br /> City State ZIP <br /> BILLING ADDRESS(42) 259 WILMA AVE <br /> If different from Mailing <br /> Address,otherwise leave blank Street No. Direction Street Name Street Type <br /> RIPON CA 95366 <br /> City State ZIP <br /> ADDITIONAL BUSINESS INFORMATION <br /> TYPE OF ❑Single Owner ❑Partnership UNSTAFFED SITE Y S <br /> ORGANIZATION(43) 1[]Corporation 19 Public Agency NETWORK(44) <br /> ASSESSOR PARCEL NO. (45) 259-170-03 <br /> PROPERTY OWNER (46) PHONE NO.(47) <br /> NAME CITY OF RIPON 209-599-2151 <br /> (If different from Business Owner) <br /> WOPERTY OWNER (48) <br /> DRESS 1259 N WILMA AVE <br /> Street Address <br /> RIPON CA 95366 <br /> CITY STATE ZIP <br /> FIRE DISTRICT NO. P7 FIRE DISTRICT (49) RIPON <br /> NAME <br /> NEAREST CROSS (50) FVE;� AVE <br /> STREET <br /> FACILITY (51) NO IF YES, <br /> LOCK BOX WHERE IS IT LOCATED?(52) <br /> NATURE OF BUSINESS (53) <br /> WATER TREATMENT <br /> WASTE GENERATOR (54) NO IF YES, <br /> WHAT IS YOUR EPA NO.?(55) <br /> TRADE SECRET (56) SPILL PREVENTION (57) <br /> INFORMATION AND COUNTERMEASURES <br /> PLAN FOR THIS FACILITY <br /> TRAINING PROGRAM INFORMATION <br /> ks your business have an employee training program that includes initial training and annual refreshers? (58) YES <br /> s 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: 1/16/04 <br />