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SITE INFORMATION AND CORRESPONDENCE
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0544173
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
2/25/2019 2:04:59 PM
Creation date
2/25/2019 10:25:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0544173
PE
3528
FACILITY_ID
FA0003613
FACILITY_NAME
ARCO STATION #4493*
STREET_NUMBER
205
Direction
N
STREET_NAME
CENTER
STREET_TYPE
ST
City
STOCKTON
Zip
95202
APN
13909003
CURRENT_STATUS
02
SITE_LOCATION
205 N CENTER ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT j <br /> i <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Information as of 6/15/2005 <br /> LOP SITE FILE INFORMATION / <br /> Case# <br /> 1042 � �0��� <br /> Site Name ARCO STATION#4493* <br /> Location <br /> 205 N CENTER ST <br /> STOCKTON,CA 95202 ` <br /> Phone 209-948-0838vim <br /> EA <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 pencil. <br /> RESPONSIBLE PARTY INFORMATION RP INFORMATION CHANGE(date) <br /> PRI-RP has been named a Primary RP. <br /> Business Name ATLANTIC RICHFIELD COMPANY <br /> Contact PAUL SUPPLE <br /> Address PO BOX 6549 <br /> MORAGA,CA 94570 <br /> Phone (925)299-889] <br /> } b0o�FS{o <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 Ordinate Codes and/or Standards and State and/or Federal Laws. <br /> PRINTED NAME:. TITLE: <br /> REPRESENTING: <br /> SIGNATURE: Date / 1 <br /> Report*8021 Date 6/1512005 <br />
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