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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# 0001473Oil <br /> Py ; <br /> it�rnt;�tat�?vetstght=, '� <br /> Site Name SHELL OIL PRODUCTS ��,. ti0i111 <br /> Location 2375 GRANT LINE RD <br /> TRACY,CA 95376 <br /> Phone r , <br /> AtKI. tk2t <br /> G <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 matte necessary changes in the space provided,date, <br /> sin and return this form. <br /> l <br /> Make changes/corrections in RED ink or pencil. <br /> RESPONSIBLE PARTY INFORMATION RP INFORMATION CHANGE(date) k <br /> PRI-RP has been named a Primary RP. t <br /> Business Name SHELL OIL PRODUCTS US <br /> Contact DENIS L BROWN <br /> Address 20945 S WILMINGTON AVE <br /> CARSON,CA 90810-1039 <br /> Phone <br /> r <br /> i��R aaa.�s�at <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 I <br /> Report#8021 Date 6/15/2005 <br />