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i 'l <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> LOCAL OVERSIGHT PROGRAM II- <br /> Responsible Party Information as of 6/15/2005 <br /> I <br /> LOP SITE FILE INFORMATION l <br /> F Case# 1299T Ilse y <br /> Site Name THRIFTY OIL 4171 ' etila � t <br /> Location 1250 N WILSON WAY <br /> STOCKTON,CA 95205g <br /> crjltVft Colt 7, <br /> ff Phone 800-800-4862 <br /> l: fib 9 <br /> E <br /> The following information is currently on file with this Department.I The Primary Responsible Party <br /> identified below will be responsible for payment of invoices for di <br /> reclt oversight charges associated with this <br /> site. If this billinginformation is not accurate [ <br /> II q <br /> , pease make necessarychanges in the space provided,date, <br /> Sinn and return this form. <br /> P Make changes/corrections in RED ink or pencil. <br /> RESPONSIBLE ONSIBLE PARTY INFORMATION RP INFORMATION CHANGE(date) <br /> is <br /> PRI-RP has been named a Primary RP. <br /> Business Name THRIFTY OIL CO <br />! Contact <br /> MICHAEL BOWERY II II <br /> Address 13116 IMPERIAL HWY <br /> SANTA FE SPRINGS,CA 90670 s <br /> I Phone (804)800-4862 <br /> k it <br /> 'I <br /> I <br /> a <br /> I <br /> I <br /> III I II <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT: I,the undersigned owner,operator,primary,i�esponsitile 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 i <br /> form. I also certify that all operations will be performed in accordance with all applicable Ordinate Codes an6for Standards and State and/or f=ederal Laws. <br /> PRINTED NAME: TITLE: <br /> ,ii <br /> REPRESENTING: 'I <br /> .i <br /> SIGNATURE: II Date 1 / <br /> Report#8021 <br /> Date 611512005 <br /> ' 3 <br /> I � <br />