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Permanent State ID Number Application <br /> DTSC Form 1358 (Revision 05120) Page 2 of 2 <br /> 10. Site Contact Person: Kevin Smith <br /> First and Last Name <br /> Contact Person's Address: 2141 E. Anderson Street <br /> Street <br /> Stockton CA 95205 <br /> City State ZIP Code <br /> Contact Person's Phone Number: (209 ^) 948 - 9701 103 <br /> Area Code Phone Number Extension <br /> Fax Number: 2c 09 ) 469 - 0862 <br /> Area Code Fax Number <br /> Contact Person's Business Email Address: KevinSmith@stocktontrl.com <br /> 11. Legal Business Owner (not property owner): James Taylor <br /> First and Last Name <br /> Owner's Address: 2141 E. Anderson Street <br /> Street <br /> Stockton CA 95205 <br /> City State ZIP Code <br /> Owner's Phone Number: (209 ) 948 - 9701 105 <br /> Area Code Phone Number Extension <br /> Fax Number: 2( 09 ) 469 - 0862 <br /> Area Code Fax Number <br /> 12. Standard Industrial Classification (SIC) Code for the Site (4-digit number): 3441 <br /> 13. Certification: I certify under.. enalty of law that the information on this document was <br /> prepared to the best of my knoe,and belief to be true, accurate and complete. <br /> Signature (handwritten): Date: 8126I2020 <br /> Name (print): Kevin Smith ( l Title: V.P. Phone: <br /> c -`MIA <br />