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l <br /> u V <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 /> y r "�: �{ L.cica]Aeencv 11se Only . ' � T <br /> Case# 18971 <br /> RernedialOverslght <br /> Site Name MOBIL SERVICE STATION Record ID R00000360= <br /> y: <br /> Location 2375 N TRACY BLVD Site Record ib SDO000360 <br /> z y <br /> TRACY,CA 95376 Facility'Record ID FA0006827 <br /> CurrentSite.:1B6si <br /> Phone 209-835-5358 . usiness BP/MOBIL SERVICE STATION; <br /> -L APN 23I A"5-5 <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 /> s. gn and return this form. <br /> Make changWcorrections 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 ATLANTIC RICHFIELD COMPANY <br /> Contact KYLE CHRISTIE <br /> Address 6 CENTERPOINTE DRIVE LPRG-161 <br /> LA PALMA,CA 90623-1066 <br /> Phone (714)670-5303 <br /> Pr4k as-194;7a <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 Ordinate Codes and/or Standards and State and/or Federal Laws. <br /> PRINTED NAME: TITLE: <br /> REPRESENTING: <br /> SIGNATURE: Date 1 ! <br /> Report#8021 Date 6/15!2005 <br /> I <br /> I <br />