Laserfiche WebLink
BUSINESS OWN I:R/OP1;RA'I'01( IDENTIFICATION PAGE SM ; 2 <br /> B SINF,SS MAILING AND BILLING INFORMATION <br /> 11 dill IN(. ADDRESS Address <br /> E..� <br /> II dillricnt from Site Address <br /> Street No. Direction Street Name SU -etType <br /> L <br /> CITY STATE ZIP <br /> BILLING ADDRESS(42) <br /> 11 different from above; <br /> uirlude "Care or' information <br /> ADDITIONAL BUSINESS INFORMATION <br /> 11'PI: t11 UNMANNED SITE NETWORK(44) NO <br /> ()RG/\NIZATION(43) FIRE DISTRICT <br /> BUSINLSS LICENSE N6. (45) EXPIRATION DATE(46) <br /> ASSESA)R PARCEL NO. (47) <br /> 007-080-69 <br /> I'ROPLRTY OWNER (48) PHONE NO. (49) <br /> NANIF <br /> tlf difft rent from Business Owner) <br /> I'ROPLRTY OWNER (50) <br /> \DDRI:SS <br /> Street Address <br /> CITY SII'ATE 'LIP <br /> DIRE DISTRICT (51) <br /> LIBERTY <br /> Ne,\Rt:S"r CROSS (52) <br /> SrREL I' JAHANT ROAD <br /> I:ACIITIY (53) OYES ❑X NO 11- YES, <br /> LOCK BOX WHERE IS IT LOCATED?(54) <br /> NATURE OF BUSINESS (55) <br /> FIRE PROTECTION <br /> WAS 1: GENERA"FOR (56) II; YES, — <br /> g YES ONO WHAT IS YOUR EPA NO.?(57) <br /> TRAINING PROGJRAM INFORMATION <br /> Does v-iur business have an emh[u)•ce training program that includes initial training and annual refreshers? (58) X YES NO <br /> Dues y,ntr business maintain written training records that show the training subject,date(s)of training, (59) <br /> X�YI?S [JNO <br /> n;rrnes .nrd signatures of'c1npluyecs trained,and names of instructor(s)? <br /> SJC 11/96 <br />