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SAN JOAQUIN COUNTY ENVILONMENTAL HEALTH DEPARTMENT <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Information as of 6/15/2005 <br /> LOP SITE FILE INFORMATION <br /> LoUse Only <br /> Rem <br /> Case# 507198 Remedial cal Aeeneyedial Oversight R000001 38 i <br /> Site Name CIRCLE K,TOSCO,UNOCAL#01205 Record ID <br /> Location 16470 S CAMBRIDGE DR Site Record ID SD0000138 <br /> LATHROP,CA 95330 Facility Record ID FA0007732 <br /> Phone Current Site Business TOSCO MARKETING CO(CIR <br /> APN 19643016 <br /> The following information is currently on file with this Department. The Primary Responsible Party <br /> identified below will be responsible for payment of invoices for direct oversight charges associated with this <br /> site. If this billing information is not accurate, please make necessary changes in the space provided,date, <br /> sign and return this form. <br /> Make changeslcortections in RED ink or ppn5o. <br /> RESPONSIBLE PARTY INFORMATION RP INFORMATION CHANGE(date) /W-<16 <br /> PRI-RP has been named a Primary RP. <br /> Business Name CONOCOPHILLIPS <br /> Contact EDWARD RALSTON <br /> Address 76 BROADWAY <br /> SACRAMENTO,CA 95818 <br /> Phone-fgt6j7}#g9}g- <br /> f} fk00 <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator,primary responsible party,or agent of same,acknowledge that all <br /> site,and/or project specific,EHD houry charges associated with this site will be billed to the party identified as the PRIMARY RESPONSIBLE PARTY on this <br /> form. I also certify that all operations will be performed in accordance with all applicable Ordinace Codes and/or StandardsandState and/or Federal Laws. <br /> PRINTED NAME: �//D �PC-L-S-N-o pJ TITLE: J(T-e CL-_ <br /> REPRESENTING: <br /> SIGNATURE: Date l!9 / <br /> Report#8021 Date 6/15/2005 <br />