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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545738
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FIELD DOCUMENTS
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Last modified
6/8/2020 11:46:47 AM
Creation date
6/8/2020 11:40:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545738
PE
3528
FACILITY_ID
FA0003715
FACILITY_NAME
Tracy Blvd Chevron
STREET_NUMBER
3775
Direction
N
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
3775 N TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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LSauers
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EHD - Public
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l <br /> CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <br /> 'I <br /> State of California ? <br /> ss. <br /> County of San Francisco <br /> 3 <br /> On February 12, 1998, before me, D. B. Collado, Notary Public ) <br /> Date Name and Title of Officere. f <br /> ( g.,"Jane Doe,Notary Public") <br /> 1 <br /> personally appeared Helen A. Weires Attorney-in-Fact <br /> Name(s)of Signers? <br /> I f personally known to me j <br /> 'I <br /> ❑ proved to me on the basis of satisfactory <br /> evidence <br /> 'l <br /> to be the persons) whose name(s) is/are <br /> subscribed to the within instrument . and <br /> acknowledged to me that he/she/they executed <br /> the same in his/her/their authorized <br /> ( capacity(ies), and that by his/her/their <br /> signature(s) on the instrument the person(s), or <br /> D.B. COLlADO � <br /> r "c the entity upon behalf of which the person(s) <br /> comm. #1027435 n Y P P <br /> U ` <br /> n: rt <br /> NOTARY FU8I1G CALIFORNIA o acted, executed the instrument. <br /> 5AN FRANCISCO COUNTY <br /> „ Noy Camm.Expires May 22,1998 <br /> WITNESS my hand and official seal. <br /> Place Notary Seal Above Signature of Notary Public <br /> '1 <br /> OPTIONAL <br /> Though the information below is not required by law,it may prove valuable to persons relying on the document <br /> and could prevent fraudulent removal and reattachment of this form to another document. <br /> Description of Attached Document <br /> Title or Type of Document_ Surety Bond i <br /> Document Date: . 2/12/98 Number of Pages: 1 <br /> Signer(s) Other Than Named Above: n/a,. <br /> Capacity(ies) Claimed by Signer. <br /> Signer's Name: <br /> ❑ Individual lop of thumb here I <br /> ❑ Corporate Officer--Ttle(s): <br /> ❑ Partner—❑ Limited ❑ General ; <br /> Zr] Attorney in Fact <br /> ❑ Trustee <br /> ❑ Guardian or Conservator <br /> ❑ Other: <br /> Signer Is Representing: United Pacific •Insurance Company I <br /> ®1997 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402 Prod.No.5907 Reorder-Call Toll-Free 1-840-876-6827 <br /> j <br />
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