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HomeMy WebLinkAboutHAZ-ONLINE INVENTORY 12/3/2008~~'~ ~ ZJnidocs - Uniform Documents '~ ~ `~-7 ~~ S ~ ~-c ~~ _ Page 1 of 2 C-~, ~~s , ~ ~ ~ ;~_ ~ ~ ~ ~~~~..~ ~ - - `- _._ whats's r~ear ~ mmnbera,~ncies ~ dacu~ b se~rvkas ~ sea~nfi umtdacs ~ co~tactns ~ r~ links ~ tr~ining a mae~ngs ~:~~~~Q~:~ ~~~~~~~~ ~~IN~~'~~~~~~~~ '~~~~~~~ Viewing/Updating Facility Information After modifying the faci lity information below, click 'Update Facility' to update the database. No Users Have Access to this Facility I. IDENTIFICATION FACILITY IDk: BEGINNING DATE (MM/DD/YYYY) ENDING DATE (MM/DD/YYYI~ 15~~ 021 __~~ 000400 _.f ~ __~._~._._....~.~..__. ___~ _...____. __. .__ _.____.~.~.~ BUSINESS PHONE (ff#tl) k##-q#!1N BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) x##k# BEDINGFIELDS AUTO REPAIR & SMOG ~ 6613238747 ~ BUSINESS SITE ADDRESS: 555 OAK ST __..__~___.____.__._ ... . .~~..~ _. ___ CITY: _.~_..__._..______ ___... ~ ~ _.__~.~.__._...__._.__._.__..__ STATE: ZIP CODE: BAKERSFIELD _ ............................................. . ~. _ . _ _ CA 93304 ) .. . . . ....................~...._......._..._.._._.... .._ _ DUN & BRADSTREET: _..... _............... ....__...~.._~_............... SIC CODE (4 digit #): ~ M 7538 ~ courv rr: • KERN . . _ _ _ ____ : .~... ._~ ..~.___ BUSINESS OPERATOR NAME: _ ~ BUSINESS OPERATOR PHONE: (#N{t) lik#-#tiN# x##ilii ALEX MADDOX _._ _______~.... _.~___. ~ ____ _______. _.____.. _.._._._~~ II. BUSINESS OWNER OWNER NAME: OWNER PHONE: (N-f#) #iiN-k~lf# x##H/t JOHN BEDINGFIELD _...........___......__..__ __.._._........._......,.._ ......................._......... ._ ; 6613238747 ~ _ ...... . . . . _ ~ _ _ .. OWNER MAILING ADDRESS: ... . . . ... ... .........._._............._._.....~..~__.....__......_. ..._ _ 5600 EVA WY ~ CITY: STATE: ~ ZIP CODE: BAKERSFIELD ~ .,.,.W ...............W......,....,...... ... .. .....,,,,,.. CA ; 93308 ! .,.,.. . . . .,,_.~ ..,,.._.,.......,,...... .. ._................ „-..,,.__.,.., _._,_.,_,...,_. ~...~.....„ .....,3 III. ENVIRONMENTAL CONTACT CONTACT NAME: CONTACT PHONE: (liN{t) ft#i1-11#iili xHkrik ALEX MADDOX _... _........_' 6613238747 ~ _._._.._. _... .. .. ~ . .. _. . _.~.., CONTACT MAILING ADDRESS: 555 OAK ST ~~~~ CITY: STATE: ZIP CODE:~ BAKERSFIELD CA 93304 _~ IV. EMERGENCY CONTACTS -PRIMARY- -SECONDARY- https://unidocs.ecointeractive.com/user/facility edit.asp?facility id=15-021-000400 12/3/2008 ~ ~^ Unidocs - Uniform Documents NAME: ALEX MADDOX TITLE: BUSINESS PHONE: (N#M) f##k-Jl~iq# xH{lttN 6613238747 ~ _...._.._........_..._......_.____ ................~...__ _ 24-HOUR PHONE: (###) IfHk-###~t xliNliN PAGER#: 6613422186 ' ... ...~ , _._ ....,._.) ADDITIONAL LOCALLY COLLECTED INFORMATION: Page 2 of 2 NAME: ALEX MADDOX TITLE: BUSINESS PHONE: (ll#ri) kilM-#1l#N x#iik# 6613238747 _~___..........____~_~.~.__~....~...~....____._..~ 24-HOUR PHONE: (N##) N#ft-##NN x#### PAGER#: 6613422186 Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certity 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) ~___..~~ ..... _____ _. .....~.__ --.___. ...,.ww__ ~: NAME OF SIGNER: NAME OF DOCUMENT PREPARER: ~,...._..... ~ ....... ~. ~_~..~........._.~ ~._.~ ~i TITLE OF SIGNER: UPCF(1/99 revised) Back. to._Acti...v...ity___Selection. OES FORM 2730 (1 /99) home ~ whaYs ngw ~.m~mber.~.~g~nci~.& I document~._~nd...rrerv~e~ ~$~~rc.h. uni_do~~ ~~9nt.a~t us reiated,_links ~ tr.a..inmg an.d meetin.gs For comments or questions regarding the HMIS project, contact the Q..n..l.i..n...e._D.at~.~t,ase„Adm...i..n..i.Str.~tQr. hosted by City_of Palo Alto https://unidocs.ecointeractive.com/user/facility edit.asp?facility id=15-021-000400 12/3/2008 ; t ~~ ~ , ~ ~ ~~ ~ ~ ,~ .~ f ~ ~ ~ { I /` ~ "1 ~ , S~ _~ ~~ ~~ _ .~~ e ~