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FIELD DOCUMENTS
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GRANT LINE
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13880
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2900 - Site Mitigation Program
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PR0508216
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Entry Properties
Last modified
1/24/2020 3:24:43 PM
Creation date
1/24/2020 3:14:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0508216
PE
2960
FACILITY_ID
FA0007997
FACILITY_NAME
MANSFIELD PROPERTY
STREET_NUMBER
13880
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
20927030
CURRENT_STATUS
02
SITE_LOCATION
13880 W GRANT LINE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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AUG-13-1999 13:52 FROM PRECISION SAMPLING TO 6634141 P.03 <br /> JOB JwORESS <br /> �10ENSED CONTRACTORS DECLARAT10 i <br /> T hereby afifirree that I am licensed under the Prarisiorrs Of 9 co <br /> 3 a/tyre "fne"and prores�ane ( mmencing wjth Section 70bb of pi�taion <br /> . fit,and rry licer+ m is bt full farce ate,�� <br /> Licensed (03iv3�j <br /> --�-..,..... Expiration D� � �� <br /> Date <br /> Sl9�aRue+e r j�C <br /> WORKERS, PEA1SAMN DEC <br /> I hereby tinder DECLARATION <br /> Pity of pmrjr+ay q"Q 0#th&�oJlawin9 drsClardtrp . <br /> 1 have and WN]R9r #Cato of CMWt to lnbin a <br /> Section 3700 of the t..abor C fpr r/r Se�_jnsurt&W war rs• <br /> ar1Co pf ►1w k%rc0"%Pens�on, as praviaed'br by <br /> 1 nave and will rr►alhtain worker's' Which UVW pert h Jr-ieisued, <br /> far the perbrmance of the+Mark fo h� insurance, as required 61►S ecti4n 37CID of Lhe Labor Cad&, <br /> aw Aeeyy�ny�urnnt e-r ares Perrot is issued. My wprt rs'�pmpen tk�h ihSwance carries <br /> Cat►'fcr-�1C1�_ �1�A�T� <br /> f"011cy Number <br /> certify ftt in'he performance of theWork <br /> enY Man ner so Se tofar which This Perrniit is issued, J shall s <br /> ahou rd b";or>t,w become Subject go flee wflrkers'eotilPe�ation not erg any Person orl in <br /> brfh A�with those 'carnperysadere raw4 of Ca%rn i and aame Drat if J <br /> P�slons. Xao of the Labor Code. I shaft <br /> Dale <br /> Signature; <br /> WARMINp.-PAILUFfe To OCCt,1gg <br /> 'W'LQYQR Tb F�LCRS'COAePEJy 71bW C�°SAOig go UN UL,AND$ <br /> (1001000),1N ADDIT LE CMAs Tlt AND COWL Fl ES Up TO ONE�ilJNt31RED SHALL SIIB,IECT <br /> D RrNrtsrtEsr, O6T rZE COmmsq ,DAISAGES as RR OUSAND DOLLARS <br /> 71M LA a <br /> D ArTc�tnll�s p OWrDED FOR IN Sm nom STOs OF <br /> TnT01 P 017 <br />
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