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STATE WATER RESOURCES CONTROL BOARD DIVISION OF CLEAN WATER PROGRAMS UST LOCAL OVERSIGHT PROGRAM STANDARD AGREEMENT NO. 9-020-550-0 NOTICE OF RESPONSIBILITY AGENCY NAME: SAN JOAQUIN COUNTY — ENVIRONMENTAL HEALTH DEPARTMENT SITE CODE: 505602 DATE FIRST REPORTED: October 2, 1995 SITE NAME: Former Shell Service Station SUBSTANCE: TPHG, MTBE, Benzene ADDRESS: 1267 Country Club Blvd. FEDERAL: (N) STATE: (Y) CITY: Stockton STATE: (CA) ZIP: 95204 RESPONSIBLE PARTY: Gary C. Escabar RESPONSIBLE PARTY CONTACT: ADDRESS: 1612 Pacific Avenue CITY: Stockton STATE: CA ZIP: 95204 Pursuant to Sections 25297.1 and 25297.15 of the Health and Safety Code, you are hereby notified that the above site has been placed in the Local Oversight Program and the individual(s) or entity(ies) shown above, or on the attached list, has(have) been identified as the party(ies) responsible for investigation and cleanup of the above site. Section 25297.15 further requires the primary or active Responsible Party to notify all current record owners of fee title before the local agency considers cleanup or site closure proposals or issues a closure letter. For purposes of implementing section 25297.15, this agency has identified Gary C. Escabar as the primary or active Responsible Party. It is the responsibility of the primary or active Responsible Party to submit a letter to this agency within 20 calendar days of receipt of this notice which identifies all current record owners of fee title. It is also the responsibility of the primary or active Responsible Party to certify to the local agency that the required notifications have been made at the time a cleanup or site closure proposal is made or before the local agency makes a determination that no further action is required. If property ownership changes in the future, you must notify this local agency within 20 calendar days from when you are informed of the change. Any action or inaction by this local agency associated with corrective action, including responsible party identification, is subject to petition to the State Water Resources Control Board. Petitions must be filed within 30 days from the date of the action/inaction. To obtain petition procedures, please FAX your request to the State Water Board at (916) 341-5808 or telephone (916) 341-5851. Pursuant to Section 25296.10 (c)(6) of the Health and Safety Code, a responsible party may request the designation of an administering agency when required to conduct corrective action. Please contact this office for further information about the site designation process. Contract Project Direct r: �� X09 li�''03�/3 Date Signature Telephone umber NEW: X Reason: Owner of property since December 28, 2011, where an unauthorized release of a hazardous substance from an underground storage tank had occurred prior to October 2. 1995 and corrective action is still required. (NOR REV 2004)