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San Joaquin Countv Locally Collected Information <br /> 38. Document Preparer: Barghausen Consulting Engineers <br /> 39. Owner/ Operator Signature—Heather Moon <br /> 40. Date—March 1, 2003 <br /> 41. Mailing Address for time sensitive information: Safeway Inc. <br /> Attention Heather Moon <br /> 2800 Ygnacio Valley Rd. <br /> Walnut Creek, CA 94598 <br /> 42. Billing Address: Safeway Inc. <br /> P.O. Box 29096 <br /> Mail Stop 6516 <br /> Phoenix, AZ 85038-9096 <br /> 43. Type of organization: Corporation <br /> 44. Unstaffed Facility Network: Not Applicable <br /> 45. Assessor Parcel No.: 121-180-41 <br /> 46. Property Owner Name: Carmen Carey, Robnick, LLC <br /> 47. Telephone Number: 408-984-1216 and fax 408-984-6304 <br /> 48. Property Owner Address: 1142 South Winchester Ave. San Jose, CA 95128 <br /> 49. Fire District: Stockton Fire Department Company 10 ISO rating Class 1 <br /> 50. Nearest Cross Street: Interstate 5 <br /> 51. Facility Lock Box: NONE <br /> 52. If"yes", where is it located?: Not Applicable <br /> 53. Nature of Business: Fuel station <br /> 54. Waste Generato: Small quantity generator including fuel filters, contaminated sump <br /> water. <br /> 55. If"yes"what is your EPA number? CAL 000 233 941 <br /> 56. Trade Secret Information: NONE <br /> 57. Spill prevention Plan: Not required <br /> 58. Employee Training Program: Included in the HMBP <br /> 59. Written training records: One file at store. Sample in HMBP <br />