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BUSINESS IDENTIFICATION FORM Pagel of 3 <br /> Main Menu <br /> BUSINESS OWNER/OPERATOR IDENTIFICATION DATA ACCOUNT#: 13138 <br /> ENTRY <br /> I. IDENTIFICATION <br /> BUSINESS NAME (4) LENSCRAFTERS #135 BUSINESS PHONE NUMBER (5) 209-477-4114 <br /> SITE ADDRESS (6) 4950 PACIFIC AVE <br /> STREET NO DIRECTION STREET NAME STREET TYPE APPT/BLDG/SUITE <br /> CITY (7) STOCKTON STATE (8) CA ZIP (9) 95207 <br /> DUN & <br /> BRADSTREET (10) 779-1013642 SIC CODE (4 DIGIT #) (11) 5995 <br /> OPERATOR NAME (12) LENSCRAFTERS INC OPERATOR PHONE (13) 513-765-6000 <br /> II. BUSINESS OWNER <br /> OWNER NAME (14) LENSCRAFTERS INC OWNER PHONE (15) 513-765-6000 <br /> OWNER ADDRESS (16)4000 LUXOTTICA PLACE <br /> ITY (17) ,ASPM STATE (18) OH ZIP (19) 45040 <br /> III. ENVIRONMENTAL CONTACT <br /> CONTACT NAME (20) ROB ROBISON CONTACT PHONE (21) <br /> CONTACT ADDRESS (22) 4000 LUXOTTICA PL <br /> If different from STREET NUMBER DIRECTION STREET NAME STREET TYPE APPT/BLDG/SUITE <br /> #6 or #41 <br /> ITY (23) MASON STATE (24) OH ZIP (25) 45040 <br /> IV. EMERGENCY CONTACTS <br /> PRIMARY SECONDARY <br /> NAME (26) C-R4" NAME (31) ROB SCHMIDT <br /> ITLE (27) GENERAL MGR TITLE (32) REGIONAL QUALITY COORD <br /> BUSINESS PHONE (28) 209-477-4114 BUSINESS PHONE (33) 916-961-2356 <br /> 24 HOUR PHONE (29) 209-275-2023 24 HOUR PHONE (34) 916-880-0747 <br /> (AFTER BUSINESS HOURS) (AFTER BUSINESS HOURS) <br /> PAGER/CELL N/A PAGER/CELL N/A <br /> NUMBER (30) NUMBER (35) <br /> EXTREMELY HAZARDOUS SUBSTANCES (EHS) <br /> ON-SITE EH&S (36) If yes, and above Threshold Quantities, attach a sheet of paper with a general <br /> description of the process and principle equipment. <br /> DDITIONAL LOCALLY COLLECTED INFORMATION (37) <br /> http://sjoesdata.org/oes hmmp/section_tables/CHMIRF_ps review.lasso?-Database=transa... 8/9/2010 <br />