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I <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL'HEALTH DEPARTMENT i <br /> LOCAL OVERSIGHT PROGRAM " <br /> I Responsible Party Information as of 6115/2005 j <br /> LOP SITE FILE INFORMATION <br /> Case# 0710 <br /> Site Name RetniEal t�v sl01al, <br /> r� ARCO STATION#5469O �l <br /> txtrI]l : a <br /> Location 130 S WILSON WAY y" � � • <br /> STOCKTON,CA 95205 <br /> Phone rrrtt Busariess ARCCtT . It) #56 <br /> 3 , _ <br /> I� <br /> AfN 155(3 <br /> Ef <br /> '7 <br /> The following information is currently on file with this Department. The Primary Responsible Party <br /> Jthis identified below will be responsible for payment of invoices fordirect oversight charges associated withsite. If this billing information is not accurate, please make necessary thanyes in the space provided,d <br /> i r r <br /> I; sign and return this form. <br /> ii. <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. t <br /> - I+ <br /> Business Name ATLANTIC RICHFIELD COMPANY <br /> Contact PAUL SUPPLE <br /> h Address PO SOX 6549 <br /> MORAGA,CA 94570 <br /> Phone (925)299-8891 I' <br /> i <br /> ;i <br /> i <br /> "F <br /> I <br /> 4 <br /> Pry boors <br /> I . <br /> i 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 /> ii PRINTED NAME: .TITLE: <br /> REPRESENTING: ' ' <br /> SIGNATURE: _ i�. Date /' 1 <br /> Report#8021 j. Date 6/15/2005 <br />