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BUSINESS IDENTIFICATION FORM • http://sjoesdata.org/ohmmp/section_tables/CHMIRF_ps_review.l. <br />Main Menu <br />BUSINESS OWNER/OPERATOR IDENTIFICATION DATA ENTRYJ ACCOUNT#:12505 <br />I. IDENTIFICATION <br />BUSINESS NAME (4) RUAN TRANSPORT CORPORATION BUSINESS PHONE NUMBER (5) 209 983-9545 <br />SITE ADDRESS (6) 837 E ROTH RD <br />STREET NO DIRECTION STREET NAME STREET TYPE APPT/BLDG/SUITE <br />CITY (7) FRENCH CAMP STATE (8) CA ZIP (9) 95231 <br />DUN & <br />BRADSTREET (10) 10-737-7780 SIC CODE (4 DIGIT #) (11) 7513 <br />OPERATOR NAME (12) RUAN TRANSPORT CORP OPERATOR PHONE (13) 515-245-5687 <br />II. BUSINESS OWNER <br />OWNER NAME (14) RUAN TRANSPORT CORPORATION OWNER PHONE (15) 515-245-5687 <br />OWNER ADDRESS (16) PO BOX 855 <br />CITY (17) DES MOINES STATE (18) IA ZIP (19) 50306 <br />III. ENVIRONMENTAL CONTACT <br />CONTACT NAME (20) ERIC MEIDENBAUER CONTACT PHONE (21) 515-245-5687 <br />CONTACT ADDRESS (22) 666 GRAND AVE 3100 <br />If different from STREET NUMBER DIRECTION STREET NAME STREET TYPE APPT/BLDG/SUITE <br />#6 or #41 <br />CITY (23) DES MOINES STATE (24) IA ZIP (25) 50309 <br />IV. EMERGENCY CONTACTS <br />PRIMARY <br />SECONDARY <br />NAME (26) MOHAMMAD KHAN <br />NAME (31) GREG FOREMAN <br />TITLE (27) LEAD MECHANIC <br />TITLE (32) REGIONAL MAINTENANCE MANGER <br />BUSINESS 209-983-9545 <br />BUSINESS PHONE (33) 909-790-5457 <br />PHONE (28) <br />24 HOUR 800 678-3210 <br />24 HOUR PHONE (34) 800 678-3210 <br />PHONE (29) <br />(AFTER BUSINESS HOURS) <br />(AFTER BUSINESS HOURS) <br />PAGER/CELL NA <br />PAGER/CELL NA <br />NUMBER (30) <br />NUMBER (35) <br />EXTREMELY HAZARDOUS SUBSTANCES (EHS) <br />ON-SITE EH&S (36) NO If yes, and above Threshold Quantities, attach a sheet of paper with a general <br />description of the process and principle equipment. <br />ADDITIONAL LOCALLY COLLECTED INFORMATION (37) <br />NAME OF DOCUMENT PREPARER (38) ERIC MEIDENBAUER <br />NAME OF OWNER/OPERATOR 39 ERIC MEIDENBAUER DATE 40 <br />BUSINESS MAILING AND BILLING INFORMATION <br />MAILING ADDRESS (41) <br />(If different from Site Address (6), Otherwise leave blank.) <br />NOTE: ALL TIME SENSITIVE AND OFFICIAL CORRESPONDENCE WILL BE SENT TO THIS ADDRESS <br />P.O. BOX 855 <br />STREET NUMBER DIRECTION STREET NAME STREET TYPE STE/APPT/BLDG <br />DES MOINES IA 50306 <br />I of 2 7/30/2010 9:28 AM <br />