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SAN JOAOUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Information as of 6/15/2005 <br /> LOP SITE FILE INFORMATION 352�v <br /> Case# 1195 <br /> �Zernedlat vers�ght" <br /> Site Name STOCKTON SCAVENGER ASSOC ,,l <br /> Record lel <br /> Location 1240 NAVY DR 5tte <br /> STOCKTON,CA 95206 1 ac111ty �' <br /> Phone 209-946-5721 , ,�, <br /> i <br /> AP C <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 /> PRI-RP has been named a Primary RP. <br /> Business Name STOCKTON SCAVENGER ASSC.INC <br /> Contact AMY DIETZ <br /> Address P O BOX 6566 <br /> AUBURN,CA 95604 <br /> Phone <br /> R ado <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 />