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i - <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> LOCAL OVERSIGHT PROGRAM <br /> I <br /> Responsible Party Information as of 6115120.05 1 <br /> i <br /> i <br /> y <br /> LOP SITE FILE INFORMATION <br /> Case# 0001296 r , a <br /> Site Name ARCO AM PM#5450* <br /> fy <br /> 1caar l <br /> sl <br /> Location 1617 W FREMONT ST W kPD 129 .q <br /> STOCKTON,CA 95203 cil tli ) I=AU t 6 ! <br /> Phone 209-462-1617 ' e� <br /> f 11 <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 isnot accurate, please make necessa chan es in the space provided,date, <br /> sign and return this form. <br /> I <br /> p Make changestcorrections in RED ink or pencil. <br /> RESPONSIBLE PARTY INFORMATION RP INFORMATION CHANGE(date) <br /> I <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 94510 <br /> Phone (925)299-8891 <br /> ft <br /> BILLING and COMPLIANCE ACKNOWLEDGEINkNT: 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 1 1 <br /> Report#8021 Date 6/15/2005 <br />