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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Information as of 6/15/2005 <br /> O <br /> LOP SITE FILE INFORMATION <br /> Case# 1772 A�ME{�TL Local„.�geti _k se t:irily <br /> U-HAUL CO#709-50 E PERMMSER\A tS Remedial Oversight <br /> Site Name Record ID R00000574 <br /> Location 2701 N WILSON WY Site Record ID SDO000574 <br /> STOCKTON,CA 95205 Facility Record ID FA00095?8 <br /> Phone 602-263-6647 Current Site Business U-HAUL CTR OF STKN#709-50 <br /> APN 117-080-14 <br /> P' <br /> The following information is currently on file with this Department. The Primary Responsible Partv <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 AMERCO REAL ESTATE CO/U-HAUL <br /> Contact 4JEfty-ftFlfjf�R L t <br /> Address a-' , I <br /> C,gNT A, g:70 <br /> PHOENIX,AZ 85004 <br /> Phone <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 Ordinace Codes and/or Standards and State and/or Federal Laws <br /> PRINTED NAME PRObO- Z k F(Zft L�n` TITLE: r✓NJ I �1M�t�r l_ ma (Ztl� <br /> REPRESENTING: Arr1iE�kC0 p.t'f�l CSS I� <br /> SIGNATURE Date 0LQ_/ <br /> Report#8021 Date 611>n_un; <br />