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UNIFIED PROGRAM CONSOLIDATED FORM <br /> FACILITY INFORMATION <br /> BUSINESS OWNER/OPERATOR IDENTIFICATION <br /> Pae of <br /> I. IDENTIFICATION <br /> FACILITY ID# <br /> L BEGINNING DATE 100- ENDING DATE 1°t. <br /> (Agency Use Only) 01/01/02 <br /> BUSINESS NAME(SmMDo <br /> rc as FACILITY NAE or DBA— ing Business As) a. BUSINESS PHONE 102. <br /> ARCO Facility No.0760 209-365-9301 103. <br /> BUSINESS SITE ADDRESS <br /> 225 S.Cherokee a. ZIP CODE 105. <br /> CITY CA <br /> L 95240 <br /> Lodi <br /> DUN&BRADSTREET 106. SIC CODE(4 digit#) 101 <br /> 09-720-0401 5541 <br /> 08, <br /> COUNTY <br /> San Joaquin <br /> BUSINESS OPERATOR NAME IN, BUSINESS OPERATOR PHONE 110. <br /> Robert Gweon 209-365-9301 <br /> II. BUSINESS OWNER <br /> OWNER NAME 111. OWNER PHONE 112. <br /> BP West Coast Products LLC 714-670-5402 <br /> OWNER MAILING ADDRESS IDs. <br /> P.O.Box 6038 <br /> CITY 114. STATE us. ZIP CODE lib. <br /> Artesia I CA 90702-6038 <br /> III. ENVIRONMENTAL CONTACT <br /> CONTACT NAME 111. CONTACTPHONE Its, <br /> Carlos Rodriguez 714-670-5402 <br /> CONTACT MAILING ADDRESS 119_ <br /> P.O.Box 6038 <br /> CITY 120. STATE 121. ZIP CODE M <br /> Artesia I CA 90702-6038 <br /> -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- <br /> NAME 123. NAME 128, <br /> Robert Gweon ARCO MAINTENANCE <br /> TITLE 124. TITLE 129. <br /> Franchisee MAINTENANCE <br /> BUSINESS PHONE 125. BUSINESS PHONE Iso <br /> 209-365-9301 (800)272-6349 <br /> 24-HOUR PHONE* 126. 24-HOUR PHONE* 13L <br /> Same (800)272-6349 <br /> PAGER# 127. PAGER# 132. <br /> N/A N/A <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: 133. <br /> Certification: Based on my inquiry of those individuals responsible for obtaining the information,I certify under penalty of law that I have personally examined and <br /> am familiar with the information submitted and believe the information is true,accurate,and complete. <br /> SIGNATURE OF OWNER/OPERATOR OR DESIGNATED REPRESENTATIVE DATE 134. NAME OF DOCUMENT PREPARER 135. <br /> C../. s!de.Aw 12/27/01 David Chambers <br /> NAME OF SIGNER(print) <br /> 136. TITLE OF SIGNER 131. <br /> Carlos Rodriguez Environmental Compliance Specialist <br /> *See Instructions on next page. <br /> UPCF hw12730(1/99)-5/37 http://w .unidocs.org Rev.04/17/00 <br />