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SAN 4OAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Information as of 6/15/2005 <br /> LOP SITE FILE INFORMATION ' <br /> Case# 0001471 Local Agency Use Only <br /> Site Name BANTA TERM INAL'UST'SITE Remedial Oversight R00001471 <br /> Record ID <br /> Location 22888 KASSON RD Site Record ID SD0001471 <br /> TRACY,CA 95376 Facility Record ID FA0003821 <br /> Phone 209-835-1097 Current Site Business CHEVRON-BANTA TERMINAL`; <br /> APN 239-060-17 <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 /> 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 CHEVRON TEXACO ENV MGMT CO <br /> Contact BOB COCHRAN <br /> Address P O BOX 6004 <br /> SAN RAMON,CA 94583 <br /> Phone (925)842-9655 <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 /> REPRESENTING: <br /> SIGNATURE: Date <br /> Report#8021 Date 6/15/2005 <br />