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SU0014352
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SU0014352
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Entry Properties
Last modified
9/30/2021 4:09:38 PM
Creation date
9/7/2021 10:39:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0014352
PE
2632
FACILITY_NAME
PA-2100172
STREET_NUMBER
27181
Direction
E
STREET_NAME
CARTER
STREET_TYPE
RD
City
FARMINGTON
Zip
95320-
APN
18726003, -04
ENTERED_DATE
8/17/2021 12:00:00 AM
SITE_LOCATION
27181 E CARTER RD
RECEIVED_DATE
9/2/2021 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Waste Management Plan Report <br /> General Order No. R5-2013-0122,Attachment B <br /> C. OWNER AND/OR OPERATOR CERTIFICATION <br /> 1 certify under penalty of law that 1 have personally examined and am familiar with the information submitted in this document and <br /> all attachments and that, based on my inquiry of those individuals immediately responsible for obtaining the information, 1 believe <br /> that the information is true, accurate, and complete. 1 am aware that there are significant penalties for submitting false <br /> information, including the possibility of fine and imprisonment. <br /> ,7ezw, A9110 <br /> Jarred Mello A,2,—1 11 35 ll>I' <br /> SIGNATURE OF OWNER SIGNATURE OF OPERATOR <br /> Jarred Mello <br /> PRINT OR TYPE NAME PRINT OR TYPE NAME <br /> Aug 2,2021 <br /> DATE DATE <br /> Mello Ranch 127181 E Carter RD I Escalon,CA 95320 1 San Joaquin County I San Joaquin River Basin <br /> 07/29/2021 11:42:02 Page 21 of 21 <br />
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