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a< <br /> Date run 12/27/2002 7:58:15A SAN JO_ UIN COUNTY ENVIRONMENTAL HEAL -[DEPARTMENT Report#5021pager <br /> Run by '"� Facility Information as of 12/27/20 <br /> Record Selection Criteria: Facility ID FA0003615 <br /> Make changes/corrections in RED ink or pen I. <br /> INFORMATION CH�datdde..,,),, I''-Z2-/�7 � <br /> OWNER FILE INFORMATION OWNERSHIP <br /> Owner ID OW0002699 New Owner ID <br /> Owner Name BP WEST COAST PRODUCTS LLC <br /> Owner DBA ARCO STATION <br /> Owner Address PO BOX 6038 DR <br /> ARTESIA, CA 90702 <br /> Home Phone 714-670-5402 <br /> Work/Business Phone 714-670-5402 <br /> Mailing Address PO BOX 6038 <br /> ARTESIA, CA 907026038 <br /> Care of RALPH J MORAN <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0003615 <br /> Facility Name ARCO STATION #760" <br /> Location 225 S CHEROKEE LN <br /> LODI, CA 95240 <br /> Phone 209-368-7863 <br /> Mailing Address PO BOX 6038 <br /> ARTESIA, CA 907026038 <br /> Care of ENVIRONMENTAL HEALTH &SAFETY <br /> Location Code 02 - LODI APN:043-140-48 <br /> BOS District 004-SEIGLOCK,JACK SIC Code: <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0003193 NewAccount ID: <br /> Mail Invoices to Owner Mail Invoices to: Owner / Facility / Account <br /> Account Name BP WEST COAST PRODUCTS LLC (circle one) <br /> Account Balance as of 12/27/2002: $0.00 <br /> (Circle One) <br /> Transfer to ActiveAmcNe <br /> Program/Element and Deacnptlon Record ID Employee ID and Name Status New Owner? Delete <br /> 2220-SM HW GEN<5 TONS/YR PR0518230 EE0008317-RAYMOND VON FLUE Active Y N A f D <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATIO PR0512979 EE0000000-HAZ MAT SJC DES Active Y N A D <br /> 2361 -NEW MULTI UST FACILITY PRO231314 EE0008317-RAYMOND VON FLUE Active Y N A D <br /> 2399-UNIFIED PROGRAM FAC STATE SERVICE FPR0507370 EE0003580-MICHELLE STERNI-LE Active Y N A D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT. I,the undersigned owner,operator or agent of same,acknowledge that all site,and/or project specific.PH&EHO hourly charges associated with this <br /> facility or activity wOl be billed to the party Identified as the OWNER on this form. I also certify that all operations will be performed in accordance with all applicable Ordinate Codes andlor Standards and <br /> Stale and/or Federal Laws. <br /> APPLICANT'S SIGNATURE: Date / / <br /> Program Records to be TRANSFERED: '$20.00= Amount Paid Date <br /> Water System to be TRANSFERED: '$155.00= Amount Paid Date / / <br /> Payment Tape Check Number R <br /> REHS: R• 00Date /I- l Z-7 / O"]- Account out: Date l l l 6 3 <br /> COMMENTS: <br /> \\Phs-ehsgl-nt\apps\Envisions\Reports\5021.rpt <br />