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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# 1181 ]'+Deal A¢encyT7se OnW <br /> Site Name UNION OIL SS#0187 IF Ftem�d1a1t7veisght � <br /> ¢ Recwd 1D 1�013p0o582 <br /> Location 437 E MINER AVE ( ,; $rfe Record IiS Slxlotkl $ .,: , <br /> STOCKTON,CA 95202 .F;aclldy RecoYd ICSAO(}t76067 ' <br /> Phone 415-945-76761 ". , <br /> APt�f 139241)17 t <br /> The following information is currently on file with this Department. The Primary Responsible Partv <br /> identified below will be responsible for payment Of invoices for direct oversight charges associated withthis <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 <br /> RP INFORMATION CHANGE(date) <br /> PRI- RP has been named a Primary RP <br /> Business Name UNION OIL COMPANY <br /> Contact JOHN FRARY <br /> Address P O BOX 1069 <br /> SAN LUIS OBSIPO,CA 93406 <br /> Phone <br /> Fl� ooa��gl <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 <br /> Report#8021 <br /> Date 6/15/2005 <br />