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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# 1136 Local Agency Use Only <br /> ' > Remedial Oversight . <br /> Site Name ARCO#4932 AM/PM Record ID 800000671 <br /> Location 16 E HARDING WAY Site Record ID.. SD0000671 <br /> STOCKTON,CA 95204 20 Facility Record ID FA0003610 <br /> Phone 209-466-9516 Current Site Business ARCO STATION#4932* <br /> 'APN .139-020-01 <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 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 ATLANTIC RICHFIELD COMPANY <br /> Contact PAUL SUPPLE <br /> Address PO BOX 6549 <br /> MORAGA,CA 94570 <br /> Phone (925)299-8891 <br /> A oa a8 705 <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: TITLE: <br /> REPRESENTING: <br /> SIGNATURE: Date / / <br /> Report#8021 Date 6/15/2005 <br />