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R <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 /> Case# 1417 <br /> - <br /> Site Name SHELL OIL CO* t#ta[CV € I00 , <br /> Location 3725 N TRACY BLVD ettrfiAipt1483 '' <br /> TRACY,CA 95376 �' :{1l .•p7,ID. AflO <br /> Phone 209-957-5398 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 changesicorrections 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 SHELL OIL PRODUCTS US <br /> Contact DENIS L BROWN <br /> Address 24945 S WILMINGTON AVE <br /> CARSON,CA 90810-1039 <br /> Phone <br /> i <br /> . s <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'ldentified as the PRIMARY RESPONSIBLE PARTY on this I <br /> form. I also certify that all operations will be performed in accordance with all applicable Ordinate Codes and/or Standards and State andlor Federal Laws. <br /> ! <br /> PRINTED NAME: TITLE: <br /> REPRESENTING: <br /> SIGNATURE: Date / 1 <br /> Report#8021 Date 6115/2005 <br /> k <br />