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BUSINESS IDENTIFICATI04ORM Page 2 of 3 <br />PAGER/CELL N/A PAGER/CELL N/A <br />NUMBER (30) INUMBER (35) <br />EXTREMELY HAZARDOUS SUBSTANCES (EHS) <br />ON-SITE EH&S (36) YESIf yes, and above Threshold Quantities, attach a sheet of paper with a general <br />description of the process and principle equipment. <br />011 [*]01It1■S11illI WK41il411114iltl4911►1its] :1u/_\Ito] 011 <br />IAME OF DOCUMENT PREPARER HOK CHOUNG MA <br />38) <br />E OF OWNER/OPERATOR (39) HOK CHOUNG MA 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 />4629 N WEST LN <br />STREET NUMBER DIRECTION STREET NAME STREET TYPE <br />STOCKTON CA 95210 <br />CITY STATE ZIP <br />LLING ADDRESS (42) <br />different from Mailing Address (41), otherwise leave blank.) <br />TE:INCLUDE "CARE OF' INFORMATION <br />4629 <br />STREET NUMBER <br />STOCKTON <br />CITY <br />OF <br />N WEST LANE <br />DIRECTION STREET NAME <br />CA <br />STATE <br />ADDITIONAL BUSINESS INFORMATION <br />LN <br />STREET TYPE <br />95210 <br />ZIP <br />C Single Owner O Corporation C Partnership O Public Agency <br />RGANIZATION (43) <br />NSTAFFED SITE NO <br />ETWORK (44) <br />SSESSOR PARCEL NO. (45) 104-370-14 <br />PERTY OWNER WEST LANE PROPERTIES INC. PHONE NO. (47) 209-957-1114 <br />E (45) <br />http://sjoesdata.org/oes_hmmp/section_tables/CHMIRF_1s_review.lasso?-Database=tran... 12/28/2009 <br />