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HomeMy WebLinkAbout1135 W COLUMBUS STREET, _ Unidocs - Uniform Documents Page 1 of 2 `~ ~ 3~ 3 ~ ~ , ~~ ~ ~, , , . '~~ ~~ ~~ ~~ . ~t~ ~ _v_ __~ __ ~~ ~~ ~ ~~~ s ~ ~ ~ ~~ ~~ ~~ ~ ~~~ ~~ . ~ ~,. _ ~hnts's ~a,r ~ rraarnha~r,~ncla~ J d~acume~rts ~! servka~s ~~ unidoca ~ carmct uffi ~ r~ia~d Itnlcs ~~ning 8 rroealingss ~;~~~~r~+~~;~ ~~~~r~~~~ ±~~~~r~~ ~~~~~~~~ ~r~rr~~~~. 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 ID#: BEGINNING DATE (MM/DD/YYYY) ENDING DATE (MM/DD/YYYY) ~ 5....,,~.' ~ 021 ...._.~ ^' 004003 : . F ~ ~.~._... ...... ~___ ' ... . .~..........~..~1 ~..........~....._....... _._.._...__ ....... .~ ..................... _ ~.._....,... BUSINESS PHONE (##N) ###-##1llf BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) x##k# AR METALS ~...; (661) 323-6883 ~ _...__...~_..._~~ BUSINESS SITE ADDRESS: 1135 W COLUMBUS STREET ~ _._ ..________ ._ _ . _~.__~ _ _ . ._ _ .._ ~ C~N~ _~ ~ _ . __._ ~ ~. ~ _~....._ ~ ~ _ .. ._. _~.~~_ _._. STATE: Z~P CODE: BAKERSFIELD ~. ~ CA 93301 ; ; .. . _. _ .~~.. ~UN & BRADSTREET: _. __ __ ___..~ SIC CODE (4 digit #): ~ ._.~.._...~ ~..~.....,.._....w _.~......_...__ COUNTY: ~ _,,._..~; ..._.__~.,,.... ._.~ KERN ~ : ~ . ~_ _._._ . _.. _~_. _ ~ BUSINESS OPERATOR NAME: _ ..._._ _ BUSINESS OPERATOR PHONE: (##It) #~kk-###tt xN### ANTONIO ROLDAN .....,,. _.~ _.._, . ~..._.___ _. _ ... ; 213 446-3342 ~ ._,,.._._. _~ II. BUSINESS OWNER OWNER NAME: OWNER PHONE: (t!##) #ilk-###1! x###N ANTONIO ROLDAN _. . ..... ~ _. ~ _. _. (213) 446-3342 ~ _._ OWNER MA~LING ADDRESS: __.. . _. __ _ .. .. _. _ ......_ _. 1135 W COLUMBUS STREET ' ______..~.~._~.~ __.~..______~..__...__.~ ... .. .. : CITY: . . . .....~..__ _,_......_.,...._._.. ~.....~.. STATE: ZIP CODE: BAKERSFIELD i CA ~ 93301 ~ III. ENVIRONMENTAL CONTACT CONTACT NAME: CONTACT PHONE: (##It) iilf#-N#tik x#### ANTONIO ROLDAN ' (213) 446-3342 ~ ~ ~ CONTACT MAILING ADDRESS: .~..,.~..~._.,..~_.._..,,,.,.._~ _..,....__~ _. . .. _ _ .~ ~ . CITY: . _. . ___~......._~. ~ .................._ :...._....,.,,...._ ~.._......_...,..,.,.,,,..........,..~.~ ~....__.__ STATE: ZIP CODE: BAKERSFIELD j ......._.. _....._ __. CA ; 93301 ! ._W _.__ ..... _......~..........~__~ _.._ ..... ._~____ __..__~.._.~....~ IV. EMERGENCY CONTACTS -PRIMARY- -SECONDARY- https://unidocs.ecointeractive.com/user/facility edit.asp?facility id=15-021-004003 12/3/2008 . Unidocs - Uniform Documents NAME: ANTONIO ROLDAN TITLE: OWNER BUSINESS PHONE: (##N) #ff~-titik# x#H##~ (661) 323-6883 _ __. ......................1 24-HOUR PHONE: (k##) k##-tt#kN xt~### (213) 446-3342 ~ ~ PAGER#: ~ .. ___~ _._.,,._.. ~___ ~ ADDITIONAL LOCALLY COLLECTED INFORMATION: NAME: ADELAIDA GOMEZ ; TITLE: WIFE ` BUSINESS PHONE: (#il#) likti-INiit# xff#tlk , (661) 323-6883....~ ......................~_.~ 24-HOUR PHONE: (#M#) N##-kNk# x#!t#{f (213) 446-3342~J PAGERk: ~ ..____. ~ ~.. ~.1 Page 2 of 2 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) 09/10/08 NAME OF SIGNER: ~~mm ~ Adelaida Gomez NAME OF DOCUMENT PREPARER: Esther assisted Owners wife 3 ~_ ~~.__ _..~..__~ _.__...._...~__~ TITLE OF SIGNER: Owner's Wife ' ~ ;JUp~ate F~a~cili;ty~~ UPCF(1/99 revised) Back. to__Ac#i._v...ity__Selection OES FORM 2730 (1 /99) home ~ whaYs n~w ~ mQmber~ ~g~n.~i.~$ ~ doc.~m~nt~._and._&~r_v_i.C.Q.~ I s~.~r~h_unf~l.Q.~~ ~ cont~Ft._~.~ related._links ~ training a.n....d....meet.i.n.gs For comments or questions regarding the HMIS project, contact the pn.l.ine._D.atab.ase. A.d.....m....ini.st.r.ator. hosted by Cj_ty of_Palo Alto https://unidocs.ecointeractive.com/user/facility edit.asp?facility id=15-021-004003 12/3/2008