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UNIFIED PROGRAM CONSOLIDATED FORM <br /> FACILITY INFORMATION <br /> BUSINESS OWNER/OPERATOR IDENTIFICATION <br /> Pae of <br /> I. IDENTIFICATION <br /> FACILITY ID# I BEGINNING DATE 100. 1 ENDING DATE 101. <br /> (Agency Use Only) 01/01/02 <br /> BUSINESS NAME(Same as FACILITY NAME or DBA—Doing Business As) 3. BUSINESS PHONE 102. <br /> ARCO Facility No. 06080 (209)983-9140 <br /> BUSINESS SITE ADDRESS 103 <br /> 85 E.Louise Avenue <br /> CITY 104. ZIP CODE 105 <br /> Lathrop <br /> CA <br /> DUN&BRADSTREET 106. SIC CODE(4 digit#) 107 <br /> 09-720-0401 5541 <br /> COUNTY los <br /> San Joaquin <br /> BUSINESS OPERATOR NAME 109. BUSINESS OPERATOR PHONE 110 <br /> John J. Serpa (209)983-9140 <br /> II. BUSINESS OWNER <br /> OWNER NAME 111. OWNER PHONE 112. <br /> BP West Coast Products LLC (714)670-5402 <br /> OWNER MAILING ADDRESS 113. <br /> P.O.Box 6038 <br /> CITY 114. STATE 115. ZIP CODE 116. <br /> Artesia CA 90702-6038 <br /> III. ENVIRONMENTAL CONTACT <br /> CONTACT NAME 117. CONTACT PHONE 118. <br /> Carlos Rodriguez (714)670-5402 <br /> CONTACT MAILING ADDRESS 119. <br /> P.O.Box 6038 <br /> CITY 120. STATE 121 ZIP CODE 122 <br /> Artesia CA 90702-6038 <br /> -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- <br /> NAME 123. NAME 128. <br /> John J. Serpa ARCO MAINTENANCE <br /> TITLE 124. TITLE 129. <br /> Franchisee MAINTENANCE <br /> BUSINESS PHONE 125• BUSINESS PHONE 130. <br /> (209)983-9140 (800)272-6349 <br /> 24-HOUR PHONE* 126. 24-HOUR PHONE* <br /> Same (800)272-6349 <br /> PAGER# 127. PAGER# 112 <br /> N/A N/A <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: 111 <br /> Certification: Based on my inquiry of those individuals responsible for obtaining the information,I certify under penalty of law that I have personally examined and <br /> am familiar with the information submitted and believe the information is true,accurate,and complete. <br /> SIGNATURE OF OWNERJOPERATOR OR DESIGNATED REPRESENTATIVE DATE 134. 1 NAME OF DOCUMENT PREPARER 135. <br /> Ci.1. '-e 12/27/01 Rachel Gross <br /> NAME OF SIGNER(print) 136. TITLE OF SIGNER 137. <br /> Carlos Rodriguez Environmental Compliance Specialist <br /> *See Instructions on next page. <br /> UPCF hwf2730(1/99)-25/37 http://www.unidocs.org Rev.04/17/00 <br />