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SU0013879
EnvironmentalHealth
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SU0013879
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Entry Properties
Last modified
4/7/2021 2:53:00 PM
Creation date
1/21/2021 1:41:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0013879
PE
2622
FACILITY_NAME
PA-2100005
STREET_NUMBER
14503
Direction
S
STREET_NAME
CAMPBELL
STREET_TYPE
AVE
City
ESCALON
Zip
95320-
APN
20732021 & 12
ENTERED_DATE
1/13/2021 12:00:00 AM
SITE_LOCATION
14503 S CAMPBELL AVE
P_LOCATION
06
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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.NOTARY <br />CERTIFICATE OF ACKNOWLEDGMENT <br />State of California <br />County of San Joaquin <br />On NQ, Df before me �.Q��0. \� �, Y�t7bC� Py1p1,L personally <br />appeared I.6 ,r K <br />who proved to me on the basis of satisfactory evidence to be the person(6) whose name(s4 is/aFe <br />subscribed to the within instrument and acknowledged to me that he/sheAhey executed the same <br />in his/hedVt eir authorized capacity(ies), and that by his/he6#t eek signature(s) on the instrument the <br />person($1, or the entity upon behalf of which the person(f3) acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing <br />paragraph is true and correct. <br />Witness my hand and official seal comm CAR <br />Ar .LIE0 <br />Le <br />Notary Public - Calitorni, <br />$tanislaus county <br />fN Comm. Expires Nov 11.2015' <br />Signature (Seal) <br />CERTIFICATE OF ACKNOWLEDGMENT <br />State of California <br />County of San Joaquin <br />Ont nc before me lC� ��`�F t �OkGC� POD\;L , personally <br />appeared V,,n>L\1 — <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 hefshe/they executed the same <br />in hiefFrerftheir authorized capacity(ies), and that by h -~their signature(s) on the instrument the <br />person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing <br />—paragraph- is true -and correct-- <br />Witness <br />orrect <br />Witness my hand and official seal <br />Signature (Seal) <br />K:EngineeringUoe FostWaterCommittee%Caton12011 Def Con Agreement.doc <br />CAALILLIE <br />Commission <br /># 1956540 <br />Notary Public - California z <br />Stanislaus CountyLo <br />' <br />�M _ - Ex irep s Nov 11'015 <br />
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