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AOIF� <br /> 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 # 1161 <br /> Site Name CHEVRON PRODUCTS Reme dial o �rsigiii: <br /> eGrfc� ID 3t�J000f1t7 "; <br /> Location 8660 LOWER SACRAMENTO RD Shy Rocord li ) UDOQgp ) 27 <br /> STOCKTON, CA 95207 Fac Ilt, . <ecmi f if? FA0063 /'6 <br /> Phone 800422-2415 Curr;iittidr, �llsine s R (€,}i'3 £,`Elgv €201v' FC3t>DSvLA1Z1' I <br /> 61FP! - 071� t7i) 0, <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 /> sign and return this form, <br /> Make changes/corrections in RED ink or pencil. <br /> RESPONSIBLE PARTY INFORMATION RP INFORMATION CHANGE (date) <br /> r <br /> PRI - RP has been named a Primary RP. _ <br /> Business Name CHEVRON TEXACO COMPANY <br /> Contact DARIN ROUSE <br /> Address PO BOX 6012 K2260 <br /> SAN RAMON, CA 94583 <br /> Phone <br /> Other RP Address 6001 BOLLINGER CANYON RD BLDG V <br /> SAN RAMON, CA 94583 <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 /> tone. 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 <br /> Report # 8021 Date 6/15/2005 <br />