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SU0010779_SSCRPT
EnvironmentalHealth
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2600 - Land Use Program
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PA-1600024
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SU0010779_SSCRPT
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Entry Properties
Last modified
11/19/2024 3:46:26 PM
Creation date
9/9/2019 10:27:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0010779
PE
2622
FACILITY_NAME
PA-1600024
STREET_NUMBER
7101
Direction
E
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240-
APN
04913052
ENTERED_DATE
2/5/2016 12:00:00 AM
SITE_LOCATION
7101 E HWY 12
RECEIVED_DATE
2/5/2016 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\7101\PA-1600024\SU0010779\SUBSUR RPT.PDF
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EHD - Public
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Vien Property SSCR <br /> Project Number:NA157033 Pane 3 of 9 <br /> August 15,2015 <br /> NEIL O. ANDERSON AND ASSOCIATES, INC. <br /> ENVIRONMENTAL QUESTIONNAIRE AND DISCLOSURE STATEMENT <br /> PART 2: OWNER INFORMATION <br /> (To be completed by Owneror Owners representative) <br /> I. GENERAL INFORMATION <br /> I. Current owner of property: <br /> Name: tN }�b �J UlLf�l <br /> Address: � 6 D NW-0— f�O, to ae I �CCcq 1r?, <br /> Telephone: o 09 -ICY ( 7h <br /> Year purchased: 4 o r <br /> 2. Previous owner(s)and contact information (if known): <br /> Name: <br /> Address: <br /> Telephone: <br /> Year purchased: <br /> 3. Other person with historical knowledge of property: <br /> Name: �i( %��F Vq <br /> Address: <br /> Telephone: <br /> Relationship to property: P'V\.6Ly-r_ <br /> 4. Please describe current use(s) of property: �aVV.A��� <br /> 5. Please describe any other known past use(s) of property, and approximate dates of each <br /> use: <br /> 1'Q,'u 'G Ce, _n <br /> z ( 3 'Rou-", � 0 Glvc�p o Q <br /> Responsive a Resourceful a Reliable <br />
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