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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# 0000738 <br /> Site Name CHEVRON PRODUCTS COMPANY <br /> Location 25651 N HWY 99 <br /> ACAMPO,CA 95220 <br /> Phone <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 /> gin and retum this form. <br /> Make changes/correWons M RED ink or pencil. <br /> RESPONSIBLE PARTY INFORMATION RP INFORMATION CHANGE(date)_ <br /> RP has been named a Primary RP. � .y� <br /> Business Name CHEVRON TEXACO COMPANY "rn <br /> Contact DANA THURMAN <br /> Address P O BOX 6012 K2236 <br /> SAN RAMON,CA 94583 rn. <br /> Phone <br /> fl�?���� <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator,primary responsible party,or agent of same,ackrwwiedge that all <br /> site,and/or prof d specific,EHD hourly charges associated with Oft site will be billed to the party identified as the PRIMARY RESPONSIBLE PARTY on this <br /> form. 1 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 />