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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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T
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TRACY
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3775
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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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EHD - Public
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CALIFORNIA ALL-PURPE ACKNOWLEDGMENT NWO, <br /> t <br /> State of a t A ECY►-,-. <br /> County of �a.-, �rar-L C_i.fc ea N <br /> On Fg 1s r a <br /> te . y I '4- llefore me, n r� TQrra_erT�n , h�b t� <br /> Patdr �, Name and Title of Officer{e.g.."Jane�o Notary Public") <br /> personally appeared P2 +a.---., k <br /> Name{s)of Signer(s) <br /> personally known to me-OR-❑proved to me on the basis of satisfactory evidence to be the person(s) <br /> whose name(s) is/are subscribed to the within instrument <br /> and acknowledged to me that he/she/they executed the <br /> same in his/her/their authorized capacity(ies), and that by <br /> his/her/their signature(s) on the instrument the person(s), <br /> - ANDREW A.TOMERSON or the entity upon behalf of which the person(s) acted, <br /> Commission# 1166523 executed the instrument. <br /> Z <br /> Fd No,ary Public-California 1 <br /> Son Francisco County <br /> WITNESS my hand and official seal. <br /> my Comm.Fires Jan 24,2402 <br /> �1 <br /> i <br /> 1 <br /> Signature of Notary Public <br /> OPTIONAL ; <br /> Though the information below is not required by taw, it may provb valuable to persons relying on the document and could prevent <br /> fraudulent removal and reattachment of this form to another document. <br /> 1 <br /> Description of Attached Document ) <br /> Title or Type of Document: <br /> Document Date: A2.,A Number of Pages: <br /> Signer(s) Other Than Named Above: At+ <br /> Capacity(ies) Claimed by Signer(s) <br /> Signer's Name: P. Signer's Name: <br /> ❑ Individual ❑ .Individual <br /> Corporate Officer ❑ Corporate Officer <br /> Title(s): 21S K; _V t7 �' 'rte e-ek Title(s): <br /> ❑ Partner—❑ Limited ❑ General ❑ Partner—❑ Limited ❑ General <br /> ❑ Attorney-in-Fact ❑ Attorney-in-Fact <br /> ❑ Trustee ❑ Trustee <br /> ElVIC1Guardian or Conservator ❑ Guardian or Conservator <br /> ❑ Other: Top of thumb here ❑ Other: Top of thumb here <br /> i <br /> �r <br /> Signer Is Representing: Signer Is Representing: <br /> r' <br /> CLteyf Pra.l�.a-C s C p <br /> CG h e„ ►�., u s zrzc 1 <br /> 0 1995 National Notary Association•8236 Remmet Ave.,P.O.Box 7184-Canoga Park.CA 91309-7184 Prod,No.5907 Reorder:Call Toll-Free 1-800-876-6827 <br />
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