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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Informatioln as of 6/15/2005 <br /> I I <br /> LOP SITE FILE INFORMATION <br /> Case# ' <br /> 1042 ; � ,....,._a... <br /> ARCO STATION#4493* <br /> n <br /> Site Name <br /> Location 205 N CENTER ST <br /> 9 � <br /> STOCKTON,CA 95202 <br /> Phone 209-948-0838 ' 3 <br /> f <br /> d <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 fir 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. F <br /> Make changeslcorrections 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 /> y <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator,primary responsible party,or agent of same,acknowledge that all <br /> site,andlor 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 andlor Federal Laws. <br /> PRINTED NAME: TITLE: <br /> REPRESENTING: <br /> SIGNATURE: Date 1 / <br /> Report#8021 ii Date 6/15/2005 <br /> I <br /> 4 <br />