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r <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> y <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Information as of 6/15/2005 <br /> LOP SITE FILE INFORMATION <br /> cai .t�Ytlsnt <br /> Case# 1039 <br /> Site Name *** R edlai ver th s r <br /> CHEVRON STATION#90557 Record s© O p to Dc , <br /> Location 139 S CENTER ST �� eot11530 #145 <br /> STOCKTON,CA 95202 l l orcttt7; U066f43 ' <br /> Phone 209-467-1625 ft <br /> AIN 33 � . <br /> i <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 changes/corrections in RED ink or penc) <br /> I <br /> RESPONSIBLE PARTY INFORMATION RP INFORMATION CHANGE(date) /30IdS' <br /> PRI-RP has been named a Primary RP. f 1 <br /> Business Name CHEVRON TEXACO COMPANY �Vtfy'r CN�1 v1tCN1t�Y1EN.�0-F' AA"!a: � 6 <br /> Contact DARIN ROUSE 7, L !t"10u52. /+ <br /> Address PO BOX 6012 K2260 ��U D�I tvt�e�✓ LGtway) E?A, K ZUab <br /> SAN RAMON,CA 94583 ZviGUMtan <br /> Phone IR4 <br /> Other RP Address 6001 BOLLING CANYON RD BLDG V <br /> SAN RAMO ,CA 94583 <br /> flsRoaa�679 <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 hourly 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 Standards and State and/or Federal Laws. <br /> PRINTED NAME: �- t'`O TITLES: �r0 6 IVlA14 c�.LA_ <br /> REPRESENTING: C'ln�tmart �11��rOvi rm&a 6 1MAtRa%a'V'Lert7C.1 Ccmpooy � <br /> SIGNADate <br /> Report#8021 c Date 6/15/2005 <br /> L _ _ <br />