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01/162004 FRI 11:22 FAX <br />11 <br />WAYNE PERRY, INC. <br />Environmental Remediation, Construction and Consulting <br />Information to fill out Business License Application <br />Business Name: Wayne P", Ino. <br />Business ' • / Main• <br />Mailing Address: Above <br />Business Phone: 916-646-98 <br />s - <br />••: <br />EmergencyAbove <br />DescriptionGeneral <br />Officers:Type of Owner -ship: Corporation <br />Ust full Names of Owners or _ <br />Preside <br />Address:• - - <br />State Ucense No: 11 •_ •: D.1 HAZ <br />Expires:01 <br />FEIN (Federal Employee t <br />SEIN (State Employee M No.): 198-2509-0 <br />sFftge <br />ar0e 212!9 <br />Policy Number; 285-02-020 <br />Number of Employees: 3 <br />Business Start Date: <br />30 Main Ave. Surae 6 Sacramento, Califomia 96836 Phone (916) 646-9680 <br />1@002/006 <br />Fax (916) 646-9683 <br />