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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545737
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
6/5/2020 2:32:19 PM
Creation date
6/5/2020 2:23:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545737
PE
3528
FACILITY_ID
FA0003627
FACILITY_NAME
ARCO 02093
STREET_NUMBER
3425
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95376
APN
21418020
CURRENT_STATUS
02
SITE_LOCATION
3425 TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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SAN JOA QUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> i <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Information as of 6/15/2005 <br /> LOP SITE FILE INFORMATION <br /> i <br /> Case# 1416 <br /> ec An <br />' Site Name ARCO9131 <br />'r Location <br /> 3425 N TRACY BLVD <br /> TRACY,CA 95376 <br /> Phone 209-835-1605 ` ° <br /> The following information is currently on file with this Department. The Prima Res onsible Par <br /> tV <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 than es in the space provided,date, " <br /> sign and return this form. <br /> Make changestcorrections In RED ink or pencil. <br /> RESPONSIBLE PARTY INFORMATION <br /> RP INFORMATION CHANGE(date) <br /> PRI-RP has been named a Primary RP. <br /> Business Name ATLANTIC RICHFIELD COMPANY <br /> i <br /> Contact PAUL SUPPLE <br /> Address PO BOX 6549 <br /> F <br /> MORAGA,CA 94570 <br /> Phone (925)299-8891 <br /> I. <br /> .j <br /> t <br /> vE <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 and/or Standards and State and/or Federal Laws. ` <br /> PRINTED NAME: TITLE: F <br /> REPRESENTING: I� <br /> SIGNATURE: Date 1 1 f <br /> Report#8029 Date 6/15/2005 k` <br /> I <br /> I <br />
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