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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Information as of 6/15/2005 <br /> LOP SITE FILE INFORMATION i <br /> Case# 0001588 ry r P I ncal A c t se'V'W'V <br /> *' K <br /> UNIVERSAL FOREST PRODUCTS I emedtal bversrghf <br /> Site Name �_ �pOppl��g <br /> g� � Record IDV <br /> Location 26200 HOWELL RD ��.°Site Record Ib SOQO(It�g7� <br /> THORNTON,CA 95686 s Facility Record ID`FAOW9531'�<e <br /> Phone 209-794-2303 <br /> i, <br /> APN 00123020 <br /> The following information is currently on file with this Department. The Primary Responsible Party <br /> , <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 /> fN—n and return this form. <br /> if <br /> Make ichangestcorrections in RED ink or pencil. <br /> RESPONSIBLE PARTY INFORMATION RP INFORMATION CHANGE(date) <br /> PRI-RP has been named a Primary RP. j <br /> Business Name UNIVERSAL FOREST PRODUCTS <br /> Contact MATTHEW MISSAD <br /> Address 2801 E BELTLINE <br /> GRAND RAPIDS,MI 49525 <br /> Phone <br /> .j <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: 1,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 /> farm. I also certify that all operations will be performed in accordance with all applicable Ordinate Codes and/or Standards and State and/or Federal Laws. <br /> i <br /> PRINTED NAME: TITLE; <br /> REPRESENTING: <br /> SIGNATURE: Date ! 1 <br /> Report#8021 Date 6/1 512 00 5 <br /> i <br />