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SAN.JOAQUIN COUNTY ENVIRONMENT L HEALTH DEPARTMENT <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Informatio as of 6/15/2005 <br /> LOP SITE FILE INFORMATION <br /> Case# 0001536 <br /> Site Name USA PETROLEUM#3696 <br /> Location 2448 W KETTLEMAN LN <br /> f <br /> LODI,CA 95240 <br /> Phone 209-369-3124 m <br /> The following information is currently on file with this Department. The Primary Responsible Party i <br /> identified below will be responsible for payment of invoices for direct oversight charges associated with this <br /> I <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 /> ake changestcorrections 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 TESORO PETROLEUM COMPANY <br /> Contact JEFFREY BAKER <br /> Address 3450 SOUTH 344TH WAY STE 100 <br /> AUBURN,WA 98001 <br /> Phone <br /> . I <br /> i <br /> i <br /> i <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&e 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 /> i <br /> SIGNATURE: Date ! / <br /> i <br /> Report#8021 Date 6/15/2005 <br />