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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0506609
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SITE INFORMATION AND CORRESPONDENCE
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Entry Properties
Last modified
11/1/2018 10:32:09 PM
Creation date
11/1/2018 2:41:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0506609
PE
2950
FACILITY_ID
FA0007536
FACILITY_NAME
SEIBOLD CORP
STREET_NUMBER
820
Direction
S
STREET_NAME
AMERICAN
STREET_TYPE
ST
City
STOCKTON
Zip
95206
CURRENT_STATUS
01
SITE_LOCATION
820 S AMERICAN ST
P_LOCATION
01
QC Status
Approved
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WNg
Tags
EHD - Public
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3 • • <br /> .CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <br /> State of W�rD�Y11 Gl <br /> County of u � Paqui 0) <br /> On beforeme, > r;(�21' MLt )rZ A (r h <br /> Woo 6M lb6 ofd '(Ie.,twr1306.Na6ry 1`101* <br /> personalty appeared <br /> flamm(s)at s9maN6) <br /> C personally known to me–OR– roved tome on the basis of satisfactory evidence to be the person(A <br /> whose nameoO is/ore subscribed to the within Instrument <br /> and acknowledged to me that ha4sMloey executed the <br /> same in his!b,-(/t}atf authorized capacityDW,and that by <br /> his,&/,tj) it signatureW on the instrument the persoro( <br /> HECTORMELENDEZ T or the entity upon behalf of which the persoW acted, <br /> CC61M.gt0�C60.9 v executed the instrument. <br /> W <br /> NOTARY PU(AIC-CAL ()RNiA <br /> SA!,;OtotfiNCDUNIY <br /> My Comm resJAN.z9,t :°ti WITNESS m d a d fficial seal. <br /> ft.me of Not6N PW t <br /> OPTIONAL <br /> Though the Information below is not required by law It may prove vaioable to persons relying on the document and Could promm <br /> fraudulent remeva/and reafrachmem of ibis tonin to another document <br /> Description of Attached Document <br /> Title or Type of Document: <br /> Document Date: - Number of Pages: <br /> Signer(s) Other Than Named Above: <br /> Capacity(les) Claimed by Signer(a) <br /> Signer's Name: Signer's Name: <br /> G fndivid¢al ❑ Individual <br /> C Corporate Officer ❑ Corporate Officer <br /> Title(s), Title(s): <br /> ❑ Partner—❑ Limited ❑General ❑ Partner—❑ Limited ❑General <br /> Attorney-in-Fact ❑ Attomey-in-Fact <br /> ❑ Trustee ❑ Trustee <br /> ❑ Guardian or Conservator REM ❑ Guardian or Conservator <br /> [IOther: Top of thumb here ❑ Other: _.. Top or mune Hare <br /> Signer Is Representing: Signer Is Representing: <br /> O 1866 N611dv�Ndary A6BC[yllan•6zae A6m+rtM11 Ave PO.Sox]ted•Cmroya Pa A.CA 91 M9]1ed Prm.No.5901 n <br /> .other,U1 anis e6 1-600-81e 6821 <br /> 20d 179L ':)NI 'D23 00 2T LG. RE ddu <br />
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