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%--' `, <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> FACILITY INFORMATION <br /> BUSINESS OWNER/OPERATOR IDENTIFICATION <br /> Pae _of 6 <br /> I. IDENTIFICATION <br /> FACILITY ID# BEGINNING DATE m0. ENDING DATE 101. <br /> (Agency Use Only) 1/9/08 3/1/09 <br /> BUSINESS NAME(S—.+FACR.rrr NAx1B.,DBA-Doi,ftuo &) 3. BUSINESS PHONE 102. <br /> Thule Towing Systems, LLC (209) 368-8881 <br /> BUSINESS SITE ADDRESS 163-- <br /> 1313 S. Stockton St. <br /> CITY 104. ZIP CODE 105. <br /> Lodi CA 95240 <br /> DUN&BRADSTREET tU6. SIC CODE(4 digit#) 107. <br /> 108-431-354 3714 <br /> COUNTY to. <br /> San Joaquin <br /> BUSINESS OPERATOR NAME 109. BUSINESS OPERATOR PHONE 110. <br /> Thule Towing Systems, LLC (209) 368-8881 <br /> II. BUSINESS OWNER <br /> OWNER NAME 111. OWNER PHONE 112. <br /> Thule Towing Systems, LLC (209) 368-8881 <br /> OWNER MAILING ADDRESS nl <br /> 1313 S. Stockton St. <br /> CITY 114, STATE 115. ZIP CODE 116. <br /> Lodi CA 95240 <br /> III. ENVIRONMENTAL CONTACT <br /> CONTACT NAME 119, CONTACTPHONE De. <br /> Fred Barunbach (209) 368-8881 <br /> CONTACT MAILING ADDRESS us. <br /> 1313 S. Stockton St. <br /> CITY 1m. STATE 121_ ZIP CODE 122, <br /> Lodi CA 95240 <br /> -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- <br /> NAME 123. NAME Its. <br /> Alberto Hernandez Fred Baumbach <br /> TITLE 124. TITLE IN. <br /> Production Supervisor Plant Engineer <br /> BUSINESS PHONE 125. BUSINESS PHONE 130. <br /> (209) 368-8881 (209) 368-8881 <br /> 24-HOUR PHONE- 126. 24-HOUR PHONE- ut. <br /> (209) 495-3455 (209) 745-2391 <br /> PAGER# Q7. PAGER# Di <br /> NA NA <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: 133. <br /> Property Owner: Phone No.: <br /> Billing Address: <br /> Certification: Based on my inquiry of those individuals responsible for obtaining the information,I certify under penalty of law that I have personally examined and <br /> am familiar with the infatuation submitted and believe the information is true,accurate,and complete. <br /> SIUNAJU OF O R/ TOR OR DESIGN D REPR ATIVE DATE 134, NAME OF DOCUMENT PREPARER 135. <br /> 9 B CDMS <br /> 14AME OF SIGNER(pin0 136. TITLE OfiISIGNER 137. <br /> Fred Baumbach Plant Engineer <br /> -See Instructions on next page. <br /> CDMS/WKI3/1-0 8 <br /> UPCF hw[2730(f/99)-12 www.unklo s.org Rev.0417/00 <br />