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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# 0712 F "' Ieta se art �5 <br /> �E�sti>~tll��E�ver�lght� � <br /> Site Name ARCO STATION#6080 1Ii ? g12 LL, <br /> Location 85 LOUISE AVE <br /> LATHROP,CA 95330 1� ,i Ili v;g rt) ,I4�t; <br /> Phone <br /> so <br /> 'i <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 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 ATLANTIC RICHFIELD COMPANY <br /> Contact PAUL SUPPLE <br /> Address PO BOX 6549 <br /> MORAGA,CA 94570 <br /> Phone (925)299=8891 ; <br /> k <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 ! I <br /> Report#8021 Qate 6/15/2005 <br />