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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> LOCAL OVERSIGHT PROGRAM <br /> Responsible Party Information as of 6/15/2005 <br /> Rol E D <br /> LOP SITE FILE INFORMATION 3.0 05 <br /> Case# 1772 ESP R NMENT HEALTH Local A„eney Use Only <br /> Site Name U-HAUL CO#709-50 PERMfT/SERVI ES Remedial Oversight <br /> Record ID R00000574 <br /> Location 2701 N WILSON WY Site Record ID SDO000574 <br /> STOCKTON,CA 95205 Facility Record ID FA0009528 <br /> Phone 602-263-6647 Current Site Business U-HAUL CTR OF STKN#709-50 <br /> APN 117-080-14 <br /> The following information is currently on file with this Department. The Primary Responsible Partv <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 /> si n 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 AMERCO REAL ESTATE CO/U-HAUL <br /> Contact 4kEJ"-itEJf#E-R L t�t <br /> Address Z� Z 1 NU(L 1-{ <br /> PHOENIX,AZ 85004 <br /> Phone Zlp 3 lnSCJ� <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 <br /> accordance with all applicable Ordinate Codes and/or Standards and State <br /> and/or Federal Laws. <br /> PRINTED NAME:PRO&C-(L-1 Foof L- , TITLE: �N�J I (.trJV�lby t�t L ►MA'�}(3L�/L <br /> REPRESENTING: PTVV%jEkCO 0.t*L C51V} It <br /> SIGNATURE: Date Ot <br /> Report#8021 Date 6/15/2005 <br />