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SAN JOS` COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> I <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Information as of 6/15/2005 <br /> i <br /> LOP SITE FILE INFORMATION '' O <br /> PA, e, <br /> Case# 1132 <br /> Site Name CONTINENTAL GRAIN CO{former} iWM <br /> la <br /> Location 1805 HARBOR ST3e _ 16' <br /> ; i <br /> STOCKTON,CA 95203 i11 ` FAfti$Q92 <br /> Phone 209-466-4261 utxerlt Iltr U. III CO f1N TAIr R II 4 y <br /> A'1+1� T fl5< k, <br /> i <br /> i <br /> The following information is currently on file with this Department. The Primary Responsible Pam <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(dafe) <br /> PRI-RP has been named a Primaa RP. <br />` Business Name CONTI GROUP COMPANIES INC <br /> Contact �0.rriE.3�Gt r �G�pY]1r12� -P+/LJ — <br /> Address '" <br /> wTr.aaVl1DV wry �A77'7� 1 Ka Y'/40 C' / <br /> Phone C_�[ _ �1� 1 6 A?) <br /> . <br /> u, <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 Ordinate Codes andlor Standards and State and/or Federal Laws. <br /> PRINTED NAME: TITLE: <br /> REPRESENTING: 7- <br /> SIGNATURE:— <br /> SIGNATURE: Date / 1 <br /> Report#8021 Date 6115/2005 <br />