HomeMy WebLinkAbout2222 F STREET15-021-000993, CIRCLE K STORE 27088?.5, 12/5/2U08 2:21:02 PM
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UNIFIEll PROG1tAM CONSOLIDATFD FORM
FACII,ITY INFORMATION
BUSIN~SS OWNElt/OPERATOR IDENTIFICATION
Page ~ of ~
I. IllENTIFICATION
FACILITY IllH
' ~ BEGINNING DATG ~0D ENDING DATE ~~~
1 5 0 2 1 , 0 0 0 9 9 3 07/01/2008 06130/2009
BUSINESSNAMB(tinmemFACILI'fYNAMG~otDDA- UoingOUSincuAs) 3 BUSINL'SS]'HONE ~~
CIRCLE K STORE 2708825 661-324-1758
ausiN~ss srrE nnnaess ~o~
2222 F ST
CITY ~~ ZIP CODE ~m
BAKERSFIELD C~ 93301
DUN & BRApSTRi:E7' ~~ SIC CODE (4 digit H) ~~
10-5457662 5541
COlJNTY lue
KERN
I3USINESS OPERATOR NAME ~~ BUSINESS OPERATOR PHONfi ~~o
MANAGER ON DUTY 661-324-1758
II. BUSINF.SS OWNER
OWNGRNAMG ~~~ OWNERPHONIi ~~2
CIRCLE K STORES INC 951-270-5793
OWNER MAILING ADDRTSS i~3
495 E RINCON RD
CITY ~~+ STATE ~~s 'LIPCODE ~~~
CORONA CA 92879
llI. ENVIRONMENTAL CONTACT
CONTACT NAML' ~~~ CONTACT PHON4 118
RICH GOSSETT 951-270-5193
CONTACT MAIWNG ADDRESS ~~~
495 E RINCON RD
C1TY ~~ STATE 12~ ZIP CODE ~u
CORONA CA 92879
-PRIMARY- 1V. F,MERCENCY CONTACTS -SECONDARY-
NAMI: ~~ NAME ~zK
SERVICE CONTACT CTR KEVIN QUINN
'1'1'fLE ~ZQ TITLE ~~9
24 HOURS MARKET MANAGER
BUSINESS PHONE ~u BUSINESS PHONE 130
866-805-4357 559-647-6910
24-HOUR PHON6 ~~ 24-HOUR PHONE ~3~
866-805-4357 559-647-6910
PAG~R N 127 PAG6R it ~~z
ADDITIONAL LOCALLY COI.LECTED 1Nf'ORMATION: ~~3
15-021 •000993-SUBMITTED•05-DECEM9ER•08
Certificaiion: Aased on my inquiry of those individuuls responsible for obtaining thc information, 1 certify under penalty of law that ] havc personally examined and
am fumiliar with the informe~ion submitted and helieve the information is tn~e, accurele, und complete.
SIONATURC OF OWNG NATED RF.P .SENTATIVE DATE 174 NAME OF DOCUMENT PREPAREK us
72/05/2008 Stantec Consulting Inc.
NAME OF SI NGR (print) ~~~ TITLE OF SIGNER 137
RICH GOSSETT ENVIR. COMPLIANCE COORDINATOR
UPCF ( 1/99 revised) OES FORM 2730 (1/99)