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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Information as of 6/15/2005 <br /> LOP SITE FILE INFORMATION <br /> Case# 1314 L4cat., cncyl.Tsat�ttly'. <br /> Site Name ARCO STATION#760* f#ehthedlsG, uetShjht .. <br /> RectntJD ?O(uJQC}3$ � ;. <br /> Location 225 S CHEROKEE LN j $d8 I'tecbed S�btili0p3 <br /> LODI,CA 95240 FaclhtyZeCoetlE? F.A(100,36t5 �� <br /> Phone 209-368-7863 <br /> APN QzG�3 140 38 <br /> The following information is currently on file with this Department. The Primary Responsible Partv <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 chanecs 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)299-8891 <br /> to a yY <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: TITLE: <br /> REPRESENTING: <br /> SIGNATURE: Date <br /> Report#8021 Date 6/15/2005 <br />