HomeMy WebLinkAboutOPERATION ID 12/18/200815-021-001253, GRAPEVINE OZL, 12/30/2008 12:07:19 AM
UNIFIED PROGRAM CONSOLIDATED FORM
FACILITY INFORMATION
BUSINESS OWNER/OPERATOR IDENTIFICATION
Page 1 of 1
1. IDENTIFICATION
FACILITY ID# ~ BEGINNING DATE ~~ ENDING DATE ~o~
1 5 0 2 1 0 0 1 2 5 3
BUSINESSNAME(SamamFACILrIVN AMEorDBA-Doin66usin¢sAs) 3 BUSINESSPHONE ~~
GRAPEVINE OIL 6613277611 ~
BUSfNESS SITE ADDRESS io3
524 DOLORES ST
CITY 104 ZIP CODE ~os
BAKERSFIELD . CA 93305
DUN & BRADSTREET ~~ SIC CODE (4 digit #) ~~
5171
COUNTY ios
KERN
BUSINESS OPERATOR NAME ~~ BUSINESS OPERATOR PHONE ~~o
LISA GUNTER . 6613277611
II. BUSINESS OWNER
OWNERNAME ~~~ OWNERPHONE ii2
Joanne Stanley 6613277611
OWNER MAILiNG ADDRESS ns
10075
CITY 114 STATE 115 ZIPCODE ~~6
BAKERSFIELD CA 93389-0075
III. ENVIRONMENTAL CONTACT
CONTACTNAME • ~~~ CONTACTPHONE ~~8
LISA GUNTER 6613277611
CONTACT MAIUNG ADDRESS - . ' - ~ ` ii9
524 DOLORE3 ST.
, , , ' ~ ' '
,. .
~
CITY , ~m STATE ` 12~ .-ZIPCODE " ~~
BAKERSFIELD ~ CA 93305
-PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY-
NAME ~~ NAME ~~s
LISA GUNTER andy carrasco
TITLE ~~ TITLE i2y
vice president sales manager
BUSINESS PHONE ~u BUSINESS PHONE ~~
6613277611 6613277611
24-IiOUR P1iONE ~~ 24-HOUR PHONE i3t
6612015020 6612015024
PAGER S 127 PAGER # ~3z
ADDITIONAL LOCALLY COLLECTED INFORMATION: i3s
. i
~r~- ~ ~ z /- ~D/zs ~3-,~~/~i~_I~~/ . 3 ~-v~ c- ~;~
Certification: Based on my inqu' of se individuals responsible for obtaining the infortnation, ( certify under penalty of taw that I have personally examined and
um familiar w' the informatio s ~tted and beli ve the information is true, accurate, and complete. •
SIG , F O ER/OPE A IGN ED REPEtESENTATIVE DATE ' ' I34 NAME OF DOCUMENT'PREPARER ' 135 '
12/18/2008 lisa gunter
NAM : SI ER (print 77TLE OF SIGNER . -
~ ~37
lisa gunter vice-president
~
UPCF ( 1/99 revised) \\ OES FORM 2730 (1/99)