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SR0084566_SSCRPT
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2600 - Land Use Program
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SR0084566_SSCRPT
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Last modified
12/29/2021 1:47:31 PM
Creation date
12/29/2021 1:43:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SR0084566
PE
2603
STREET_NUMBER
18201
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
MOUNTAIN HOUSE
Zip
95391
APN
20945035
ENTERED_DATE
12/6/2021 12:00:00 AM
SITE_LOCATION
18201 W GRANT LINE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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8 1 Page <br />C. Any notices from any governmental entity regarding any <br />possible violation of environmental laws or possible liability ❑ ❑X ❑ <br />relating to hazardous substances or petroleum products? <br />ENDORSEMENT: <br />Part 2 <br />Being the present owner of the property (officer, general partner of the present owner, or the duly <br />authorized representative) I am familiar with all of the operations presently conducted on the property. <br />Furthermore, I certify that to the best of my knowledge, information, and belief the information disclosed <br />above is true. <br />I hereby give permission to Petralogix Engineering, Inc. to enter the subject property, as necessary to <br />complete the Surface & Subsurface Contamination Report. <br />Prabhjot Singh 11/08/2021 <br />Signature date <br />Prabhjot Singh <br />Name (Please Print) <br />Owner/Developer <br />Relationship to property <br />Contact Phone Number (209) 634-4832 <br />le.petralogix <br />26675 Bruella Road - Galt, CA 95632 • 209.400.5729 <br />
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