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PR0231136
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BILLING_PRE 2019
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Entry Properties
Last modified
2/26/2024 1:19:00 PM
Creation date
11/5/2018 3:01:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0231136
PE
2361
FACILITY_ID
FA0003610
FACILITY_NAME
A&A GAS & FOOD MART
STREET_NUMBER
16
Direction
E
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95204
APN
13902001
CURRENT_STATUS
01
SITE_LOCATION
16 E HARDING WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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KBlackwell
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EHD - Public
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EXERCISE OF POWER OF ATTORNEY WHERE <br /> MORE THAN ONE AGENT DESIGNATED <br /> If I have designated more than one agent, the agents are to act <br /> IF YOU APPOINTED MORE THAN ONE AGENT AND YOU WANT EACH AGENT TO BE ABLE TO ACT <br /> ALONE WITHOUT THE OTHER AGENT JOINING, WRITE THE WORD "SEPARATELY" IN THE BLANK SPACE <br /> ABOVE. IF YOU DO NOT INSERT ANY WORD IN THE BLANK SPACE, OR IF YOU INSERT THE WORD <br /> "JOINTLY,"THEN ALL OF YOUR AGENTS MUST ACT OR SIGN TOGETHER. <br /> I agree that any third party who receives a cop,, of this document may act under it. Revocation of the <br /> power of attorney is not effective as to a third party until the third party has actual knowledge of the revocation. I <br /> agree to indemnify the third party for any claims that arise against the third party because of reliance on this <br /> power of attorney. <br /> Signed this `� day of <br /> :1� -,/p "k kc�� <br /> (your signature) <br /> <br /> (your Social Security number) <br /> State of / <br /> , County of <br /> BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT ASSUMES THE FIDUCIARY <br /> AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT. <br /> CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC <br /> State of California <br /> County of <br /> On 64, 2Z — 13 before me, J q W)e-'s. � cLII OL V,— , a notary public, <br /> personally appearedwho <br /> proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are sibscribed to <br /> the within instrument and acknowledged to me that he/she/they executed the same in His/her/ticir <br /> authorized capacity(i,&s), and that by Otis/her/theif signature(s) on the instrument the person(s), or the <br /> entity upon behalf of which the person(s) acted, executed the instrument. <br /> I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing <br /> paragraph is true and correct. <br /> WITNESS my hand and official seal. <br /> JAMES NALLAN <br /> i Commission # 1937286 <br /> Z(@My <br /> Notary Public-California zSignature / Santa Clara County <br /> � eal) Comm.Expires May 20,2015 <br />
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