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CO0003807
EnvironmentalHealth
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2500 – Emergency Response Program
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CO0003807
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Entry Properties
Last modified
8/22/2023 11:18:06 AM
Creation date
1/30/2019 4:38:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0003807
PE
2531
FACILITY_NAME
STAR BUILDING
STREET_NUMBER
12101
STREET_NAME
BRANDT
STREET_TYPE
RD
City
LOCKEFORD
ENTERED_DATE
5/9/1995 12:00:00 AM
SITE_LOCATION
12101 BRANDT RD
RECEIVED_DATE
5/8/1995 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\bmascaro
Supplemental fields
FilePath
\MIGRATIONS\B\BRANDT\12101\CO0003807.PDF
Tags
EHD - Public
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i <br /> i <br /> ATTACHMENT I <br /> CERTIFICATION STATEMENT <br /> I certify under penalty of law that this document and all attachments were prepared under <br /> my direction or supervision in accordance with a system designed to assure that qualified <br /> personnel properly gather and evaluate the information submitted. Based on my inquiry <br /> of the person or persons directly responsible for gathering the information, the <br /> information submitted is, to the best of my knowledge and belief, true, accurate and <br /> complete. I am aware that there are significant penalties for submitting false information, <br /> a including the possibility of fine and imprisonment for knowing violations. <br /> 1 <br /> i : <br />
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