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SAN JOAQUIN 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 352 <br /> Case# 1554 a1'A e se <br /> � � I <br /> Site Name edlalC>vrgh K <br /> BP OIL/TOSCO#11195 {} wo <br /> 6ec <br /> _ <br /> Location 16500 S I-5 FWY <br /> ite� ct�' MI5 (? bye <br /> LATHROP,CA 95330 F; Illtyt 1 `$ SFr <br /> Phone 209-983-0381 <br /> PN 198 O1 <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 /> I <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 CONOCOPHILLIPS <br /> J <br /> Contact EDWARD RALSTON <br /> Address 76 BROADWAY <br /> SACRAMENTO,CA 95818 <br /> Phone (916)714-2910 <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 /> i <br /> REPRESENTING: <br /> SIGNATURE: Date <br /> Report#8021 Date 6/15/2005 <br />