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SITE INFORMATION AND CORRESPONDENCE_FILE 2
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545246
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SITE INFORMATION AND CORRESPONDENCE_FILE 2
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Last modified
1/30/2020 4:05:50 PM
Creation date
1/30/2020 1:53:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 2
RECORD_ID
PR0545246
PE
3528
FACILITY_ID
FA0003611
FACILITY_NAME
PARKWOODS GAS & FOOD
STREET_NUMBER
1612
Direction
W
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95209
APN
07728002
CURRENT_STATUS
02
SITE_LOCATION
1612 W HAMMER LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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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# 1127 ' At b�?tx3'1 JSe Oni1v- <br /> Site Name ARCO 4 548 <br /> 1€3'.AQWW031, <br /> Location 1612 W HAMMER LN5 of i#t Sf fJ O <br /> STOCKTON,CA 95207 Filit3i Ir�F 1E3Afi? 363 <br /> Phone Ot rit at1 sate PAlI1 YOOI , ilpA O * a <br /> 3 APiN' <br /> 07.2$13 t}2'., 1 <br /> . d <br /> The following information is currently on file with this Department. The Primary Responsible Party <br /> identified below will be responsible for payment of invoices for direct oversight charges associated with this <br /> site. If this billing information is not accurate, please make necessary changes in the space provided,date, <br /> s$and return this form. <br /> Make changeslcorrections 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 /> 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 />
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