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AtMAMZ <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 /> Local Agency Use Only <br /> Case# 1213 <br /> Site Name Reirsedial Mersight <br /> UNOCAL#SS/2859 Record ID.:'.. 104585 � y <br /> Location 1665 PACIFIC AVE Tti Site Record Ib SDOpt)p5&5 j <br /> STOCKTON,CA 95204 Faciiity Record 1D FP►p4t)5 98 <br /> Phone 415-945-7676 Current Site Pasmess'UN1ON OIL SS 2859 <br /> APN s,, = <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 UNION OIL COMPANY <br /> Contact JOHN FRARY <br /> Address P O BOX 1469 <br /> SAN LUIS OBSIPO,CA 93406 <br /> Phone <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1,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 /> I <br />