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COMPLIANCE INFO_2020
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1900 - Hazardous Materials Program
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PR0521083
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
2/21/2020 4:33:28 PM
Creation date
1/24/2020 8:53:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0521083
PE
1921
FACILITY_ID
FA0001818
FACILITY_NAME
BULLFROG LANDING MARINA
STREET_NUMBER
17251
STREET_NAME
BACON ISLAND
STREET_TYPE
RD
City
STOCKTON
Zip
95219
APN
12917003
CURRENT_STATUS
01
SITE_LOCATION
17251 BACON ISLAND RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 <br /> A notary public or other officer completing this certificate verifies only the identity of the individual who signed the <br /> document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. <br /> State of California ) <br /> County of ) <br /> On le,4 /%`' before me, CANA LL X--\C)\c•c <br /> Date \ Here Insert Name and Title of Officer <br /> personally appeared � Lc \ ) <br /> Name(s) of Signer(s) <br /> who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are <br /> subscribed to the within instrument and acknowledged to me that he/she/they executed the same in <br /> his/her/their authorized capacity(ies), and that by his/her/their signature(s)on the instrument the person(s), <br /> or the entity upon behalf of which the person(s) acted, executed the instrument. <br /> I certify under PENALTY OF PERJURY under the laws <br /> of the State of California that the foregoing paragraph <br /> is true and correct. <br /> HOLLY DUTRA WITNESS my hand and official seal. <br /> Notary Public-California <br /> Contra Costa County <br /> Commission#r 2149841 Signature�IlZ� 6�. <br /> M Comm.Expires Apr 21.2020 gnature of Notary Public <br /> Z <br /> Place Notary Seal Above <br /> OPTIONAL <br /> Though this section is optional, completing this information can deter alteration of the document or <br /> fraudulent reattachment of this form to an unintended document. <br /> Description of Attached Document <br /> Title or Type of Document: Document Date: <br /> Number of Pages: Signer(s) Other Than Named Above: <br /> Capacity(ies) Claimed by Signer(s) <br /> Signer's Name: Signer's Name: <br /> i-' Corporate Officer — Title(s): 11 Corporate Officer — Title(s): <br /> ❑ Partner — Ll Limited ❑ General ❑ Partner — i_] Limited LJ General <br /> ❑ Individual I Attorney in Fact ❑ Individual 1-1 Attorney in Fact <br /> Cl Trustee ! Guardian or Conservator ❑Trustee 1-1 Guardian or Conservator <br /> LI Other: F1 Other: <br /> Signer Is Representing: Signer Is Representing: <br /> 02014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5907 <br />
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