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HomeMy WebLinkAboutBUENA VISTA ROAD~ `'Unidocs - Uniform Documents ~~~ rj~] (~ ~ ~ ~ l~~,~~~~~~~ ~I~~~t"I~~~ ~~~II~~ Ir~'~'~~~ P~!'"t~j ~ .~ ~ ~ ~ Page 1 of 2 Viewing/Updating Facility Information After modifying the facility information below, click 'Update Facility' to update the database. FACILITY USERS Name Phone Number Email C.ynthia._J...._P...a...ppas. 925-415-6302 cip2.@p~e..com I. IDENTIFICATION FACILITY IDq: BEGINNING DATE (MM/DD/YYYY) ENDING DATE (MM/DD/YYYY) 15 ) ~ 021 ~ ~ 004012~ ~~ ~ ~ ~ BUSINESS PHONE (H##) ##k-###N BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) xN#~tH PG&E KERN RIVER STATION ' "'~ ~.__~ _.. _. __.~__..__....___ _..._~._~_._____.~ ____________.~._~ ~ ..............._... .................._........._.. _? BUSINESS SITE ADDRESS: 2.0 MI W/O BUENA VISTA RD 1.75 MI S/O STOCKDALE HW ___....._._._~_ ......................._--._............_.............._.._.._..._.._......................__............_ _---....................~.._....___....__.._._.........__......._._..____._._.....~............................_......_.........__.. CITY: STATE: ZIP CODE: BAKERSFIELD ~ ~~ ~~ CA 93307 ~~~ DUN & BRADSTREET: SIC CODE (4 digit #): _......_ _......._ ; 1 _...... I COUNTY: KERN BUSINESS OPERATOR NAME: BUSINESS OPERATOR PHONE: (k#ri) ###-#k## xtl#k# __.__ .____ _~.__......_~__ ~ .v_. __.___.. ._..___._._.._..~ _... .. _.__ _ _ ~ .~._.._...~._.___~ _ _1 II. BUSINESS OWNER OWNER NAME: OWNER PHONE: (k##) #HN-Ht!#N x##ril! ; ~ __...__._______,...~.._____.__~_._.~~.__~_.W_______._..._.........._.___.~__W_W______.....__._._._.? .~~________..,._....___. __.__~.~.._.[ OWNER MAILING ADDRESS: __..... _._........ __...... , CITY: STATE: ZIP CODE: i __.. . ~. _. _ _.___..~__._.._...~__ ? III. ENVIRONMENTAL CONTACT CONTACT NAME: CONTACT PHONE: (##N) t!#ll-#Ifif# x#N#1i F i ......,......,........~.m.~.....,...~ ...................,.......... ....... ~ ................................................_._..rv.._....,,............,.................,.~ CONTACT MAILING ADDRESS: ... , _ _ .. . . .. . ........ ; CITY: STATE. ZIP CODE: ~ ? ~- ~ https://unidocs.ecointeractive.com/user/facility edit.asp?facility id=15-021-004012 12/3/2008 "Unidocs - Uniform Documents Page 2 of 2 IV. EMERGENCY CONTACTS -PRIMARY- NAME: TITLE: ~ ____ _.__ _____ _ ~ .__.~._._._~ __~ .__: BUSINESS PHONE: (###) #i##-~Itf#N xf#~iN# a a ........._ ..............................._......_........__............__._.._..........~ 24-HOUR PHONE: (ttN#) #NN-Ntf#N xk#k# ~ _.~..._1 PAGERN: ~ _ _.~__ __... . _ ~ ADDITIONAL LOCALLY COLLECTED INFORMATION: -SECONDARY- NAME: ~ 3 TITLE: WW~ ~~ BUSINESS PHONE: (#Hli) #k#-NkM# xlf##ii , __.~_._....____~._.~.___...._._ ................~........_.~...._.~~~~.~ 24-HOUR PHONE: (#tIM) tlk#-ti~ik# x###ii ~ ~ PAGER#: ___W__r _ .___,..__.. ~ _._ ___._...~ Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penaltyof law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. DATE: (MM/DD/YYYY) NAME OF SIGNER:~ ~mm~~ NAME OF DOCUMENT PREPARER: TITLE OF SIGNER:~ mm_~~mm~m~~Y.~ i .........,..r__~_.~.....~.._..._ ............................._._~_~_~_...__......3 UPCF(1/99 revised) Back._to._Acti..v,ity.._Sel.ection. OES FORM 2730 (1 /99) home ~ what's new ~ members agencies ~ documents and services ~ search unidoc§ ~ contact us r~lated_links ~ t~afning and m~et.j.~gg. For comments or questions regarding the HMIS project, contact the Online._Database_Administrator. hosted by Citv of Palo Alto https://unidocs.ecointeractive.com/user/facility edit.asp?facility id=15-021-004012 12/3/2008