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I <br /> 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 /> W. <br /> www <br /> c � ency V <br /> 1554 <br /> Case# �� P . <br /> Site Name BP OIL/TOSCO#11195 <br /> eeo 1R , OOp0006 <br /> Location 16500 S 1-5 FWY i e40 <br /> cor S �8& <br /> MOW <br /> LATHROP,CA 95330 FaI�Ilty Re ! " q _ b <br /> Phone 20?983-0381 CiUrtn St USt <br /> ,P <br /> 1 8 t ' <br /> r <br /> The following information is currently_on file with t�Iis.Aei►artment_,The.]P_r..i-maryesl�o�;sible_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 changes/corrections in RED ink oril��i <br /> RESPONSIBLE PARTY INFORMATION RP INFORMATION CHANGE(date) <br /> PRI-RP has been named a Primary RP. <br /> Business Name CONOCOPHILLIPS <br /> Contact EDWARD RALSTON � <br /> Address 76 BROADWAY <br /> i <br /> SACRAMENTO,CA 95818 <br /> Phone <br /> i <br /> I <br /> i <br /> r <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 taws. <br /> PRINTED NAME: F—D nV\R--L—S—%—b-fJ TITLE: <br /> REPRESENTING: <br /> SIGNATURE: �– Date (4:1 / lib / 0 S <br /> Report#8021 Date 6/15/2005 <br /> j <br />