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WP0038414
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ZUCKERMAN
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2121
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038414
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Entry Properties
Last modified
9/10/2018 2:08:38 PM
Creation date
9/10/2018 1:33:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038414
PE
4372
STREET_NUMBER
2121
Direction
N
STREET_NAME
ZUCKERMAN
STREET_TYPE
RD
City
STOCKTON
Zip
95206-
APN
12908009
ENTERED_DATE
6/12/2018 12:00:00 AM
SITE_LOCATION
2121 N ZUCKERMAN RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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DAfonskaia
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EHD - Public
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Joe Amaawa Z/ Z1 /y . <br />LICENSED COMPACTORS DECLARATION <br />1 hreby a4n ftet I am laerued hada the prorlsla - d Chapbr t (0or,rnmhabra rdfh 3 don 7000) d WmWOn J Of" aminase wd <br />Phobwiorw Code -red eM ran.. IS r, u wince and GMSC. <br />Lhewee 0 _/{ o <br />Dar t' % ./ <br />OWNEA4MJXDER DECLARATION <br />Dab <br />I hereby aBrm Md I am erorgt torn On Cant cuts Umeme Law for ft kdowk ^mem (Sado^ 7031 A Sueirneee wd Piolmwione <br />Code_ Any ray or Omedy which requdne a pwnf b eoreM+eeI air. YnPew+. deeMldr, at ^Pet ON elucluv% plor b on ku--e, <br />she requires ft apprrad br much perm b re a sighed etsisnhw I fid lw is kwmd purmmt b ft prahbrM d the Codncbte <br />Weems Lary (Cllepbr I (aoaaasnobhp nNf Seaton 7000) d DO 1, f of ft Ilrinen end Probe" Cale) or Md he Is enswo <br />heriore rad ft basis lo► to alleged eesnpforh Any vbis/ow d Secfon M11 by any appkert b► a pwwA aabf wile f» apple wt <br />b - dwilpwMfy d wet rerore than fro hehDOed dons (SW0 <br />w Oeww d h prnpwty, or aey enpbyeee elfh wow w 01* Sole 'm l: wibr4 wit do ftwork mrd Pseatuck" b not <br />to <br />br raft (3a7on ?M, blmtues and PlObeeblle Cadet The 0040110110fe mervee Use does rot apply b en <br />0WW d property who burble or 1Rhplorw fwow4 and who dos suds salt hbrmef or ferarph his err ewlpbyeee, prodded tut <br />meth brprorerrhwda we net btrnded or OAerad for ask. IL however. to bufOnQ or I nprorwaert Is sold wWdn ate yen of <br />oonrplaforL ft owner -bulkier will hew to Iern of prortq fed he did not build or fmprore for fte purpose of Sob.) <br />O L ore a ew of to properlyern As, a 11 contwdbh f wM foermed eordrac on b conebuCl fes propd (11 A 70x4. Su mimes end <br />PrOSeaMeo Cads (f1PC); The Owetadofs t.bww herein OM nor appy to ea winter of prapwty hMr hAde or I qx her <br />wd who aorrthrls for mach pea jeab w ilh a oontador(s) iawred Wrsuwt b to Ca/adofa Uc< LAW) <br />O I am Sawing- urdw Seefon SLPC for fob noon <br />Dar: 7W -G - />7 Ower <br />WORKr"' COMPENSATION DECLARATION <br />1 hwsby -irD f W 1 hoe a owkic-1 ofoorwrt b ael4neure a s OSrlfeeb d Wcm ho Congwreeon bhmswo, ora r+Med appy <br />Mmed (Sed lon 311M Labor Code). / �/{/���- - <br />U*.B. Dora iv -/-20/1 CoaeperW F—Af-feA i4na I c= /"& g CI. <br />O Cowed copy Is hereby funeblad <br />M CwMW copy h fled with fM Enrtaweer+ul Hedfh Depwar- <br />CERTIFICATE OF EXEMPTION FROM MIORXFRS' COMPENSATION INSURANCE <br />I awry fed In fin pwforerwers d h wort for none fele post is based. I of W rod wepioy wry Pweorh In wry rtemer w so b <br />beoonw aubjed b fte Wortws' CODyuteaton Lore d CaWrde <br />DMS: <br />NOTI6t TO APPUUMr.. K aibr ww11 Milk CerMceu d Mrnrpe N you d"M taooau nerjed b the Wa1sm Congwteebn <br />prwrbrte d to Labor Code. you "m low -M 00,00 w/h ouch prodebne ce fhb pemrM Shell be dewed ranslwd <br />CONSTRUCTION LENDING AGENCY <br />1 N"by Mur VW fMn is ■ aorrtu,4an Iwhdrq ap -y bin to pwbraMnds of to wait for elect Me pont is herd (Seebn W97. <br />Clea Codd <br />Iarbfs Ilwwe <br />Lender's Address, <br />DMEION OF WDUSTRIAI SAFETY PERid1T CERTFICATIOM <br />O 1 Irreby am* feet no weosrrdon We (5) or awn feel in depQ kto whfah a person b rwghired b d..aw I will be nude in <br />corrhacforh wM wok w =tmd by ft peracl and fMl no bu§&V nNuclum wmOoWkl& bbanork or dsmofroe or dmrwftV <br />fW nd. will be non fon d+LIV (3M feet high. (Chepeer S2. Oras 2. Arfcb E Beck, 311, TTI* A Cafbrrde AdniebteWre <br />O As o w er-boder, I will rot empty anyate In do wo* w- "I would nqA a panNt torn M MUM Of btltrtW Sddy. me Dowd <br />-bow. uriw mint pwean her a perwi b do eudh work from to Orieiom <br />on, — d Ydm*W Sddy Pemhl 0 <br />I ower fwt I haw Ped *A appfeafon ane qab tW IAS shore Irdownsasn is OX ' I SIM b Owl* wMh M dy sea Oourdy <br />adereoee wd syr bw raI I b ref catebhckri wed or im eP ryebm c0uberAm and hmeby anlnrfaa npnwt-fro d VIA <br />odmty b anew upon ft obowmorfOrted properly for 1rMped , p+poos. <br />Dab <br />•O gaeaar UCOMMD OOwTFACTOM D-CUMAnoN <br />eae�a <br />
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