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HomeMy WebLinkAboutBUS. OWNER/OPER. ID 12/29/200815-021-003417, TRACTOR SUPPLY C0, 12/30/2008 9:30:49 AM UNIFIED PROGRAM CONSOLIDATED FORM FACII..ITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION Page 1 of 1 I. IDENTIFICATION FACILITY 1D# ~ BEGINNING DATE ~~ ENDING DATE ~o~ 1 5 :`_ 0 2 1 '.:~:: ~ 0 0 3 4 1 7 BUSINESSNAME~SameasFACILITYNAMEorDBA-DoingBusinas As) 3 BUSINESSPHONE 102 TRACTOR SUPPLY CO 6615891504 BUSINESS SITE ADDRESS 103 2749 CALLOWAY DR CITY ~~ ZIP CODE ios BAKERSFIELD C`~' 93312-2639 DUN & BRADSTREET ~ab SIC CODE (4 digit #) ~o~ 5999 COUTdTY ios KERN BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PHONE ~~o TRACTOR SUPPLY COMPANY 615-440-4600 II. BUSINESS OWNER OWNERNAME ~ ~~~ OWNERPHONE 11z TRACTOR SUPPLY COMPANY 615-440-4115 OWNER MAILING ADDRESS ~~3 200:POWELL PLACE ._ - : CITY t.14 , STATE ;' ,iis ' ZIP.CODE. . _ _ iie-- . BRENTWOOD,.~%.: ~.~ .. . -: , ._ ,. , .. . . ,... ._ . _._... ...._.. , ...~; ~: . :~. ._.. ; ,.. ~ _ .. . TN . . ~ 37027 ,., :::~: . ; ~ ,~ ... ... ...... ...... _ _ _ _ _ _.. _ .. .. .._.... .. . _....... . __.... . ..... . ' ' ' " ' ' '" ' ' ~ ~ ' ` III: ENVIRONMEN•TAI; CONTACT . .. ,~ , . „. . , .~..... . . . , ,. , . .. ; CONTACT NAIVIE . . ~ ~ . _ _.. ... ... .. __ . . _. _ .__ . . _ __ _ . - =-- .__. i iz CONTACT-PHONE .. -_ _ . . .. ' ' . "_.: . ' ~ _` . ~ ~a BRIAN SPEARS 615-440-4115 CONTACT MAILING ADDRESS ~~9 200 POWELL PLACE CITY ~ZO STATE 1z~ ZIP CODE izz BRENTWOOD TN 37027 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME ~2s Np~,¢ i2s BRIAN SPEARS RICK ROCCO TITLE 124 TITLE 129 SAFETY MANAGER STORE MANAGER BUSINESS PHONE 125 BUSINESS PHONE ~30 615-440-4115 661-589-1504 24-HOUR PHONE 126 24-HOUR PHONE ~3~ 615-210-5503 PAGER # 127 PAGER # ~32 ADDITIONAL LOCALLY COLLECTED INFORMAT[ON: ~33 . ._.~.S..p:Lr ~a~.3Y-~_"~_.. _ __._ _ , ... . , . .. . _..._ . _ _ _. _ .__. ___. _ _ _ _ _ _........ _ ..... _ . ~ ~~ ..... , , ., ,.~ ... Certi6cation: Based on m ~ri u' '"~ po ' y' q uy of those~individuals res nsible .. ..... ' forobtaining the infonnation,-I certify'under penalty of law that [.have.personally.examined and ~:: am familiar ' ' orm ' bmitted and believe the information is triie; accurate, and coriiplefe:, :".,:.. _ ....-- - . ___ .._ _.... . _._... . _. . .... . ...._ .... _ . SIGNATU WNER/OP R OR DESIGNATED REPRESENTATNE DATE ~. ~,,• 134 --NANfE OF DOGUMENT PREPARER"'°" --- ------- ~ ~ 135 . '' _ --- _ . .. _. _.._ _ _ 12/29/08 : . . ._. BRIAN S PEARS.: NAME OF -GNER,(print) 136 TITLE OF SIGNER "~ -" ' - -' ' - - 137 ~ BRIAN SPEARS SAFETY MANAGER UPCF ( 1/99 revised) OES FORM 2730 (1/99)