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CORRESPONDENCE_2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4400 - Solid Waste Program
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PR0504201
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CORRESPONDENCE_2019
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Entry Properties
Last modified
1/19/2024 3:12:51 PM
Creation date
5/20/2022 11:54:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4400 - Solid Waste Program
File Section
CORRESPONDENCE
FileName_PostFix
2019
RECORD_ID
PR0504201
PE
4430
FACILITY_ID
FA0000214
FACILITY_NAME
PILKINGTON NORTH AMERICA INC PLANT 10
STREET_NUMBER
500
Direction
E
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
LATHROP
Zip
95330-9739
CURRENT_STATUS
01
SITE_LOCATION
500 E LOUISE AVE
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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I <br />A notary public or other officer completing this certificate verifies only the Identity of the individual who signed the <br />document to which this certificath Is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of California ) <br />County of____________________ } <br />On N before me, U ç\J ( v <br />Date Here Insert Name and Title of the Officer <br />personally appeared <br />Name(s of S(gnet's) <br />who proved to me on the basis of satisfactory evidence to be the person whose name( /aè <br />suscribed to the within instrument and acknowledged to me that l'/stIeItby executed the same in <br />lia/hr/thieir authorized capacity(), and that by 6fh/tWeir signature() on the instrument the person(J, <br />or the entity upon behalf of which the person(S) acted, executed the instrument. <br />4ALICCDOL1 J3 Comm. #2153598 , <br />Notary Public. California <br />L4 \j7 Sacramento County <br />_Comm.Expires May19,2020 <br />I certify under PENALTY OF PERJURY under the laws <br />of the State of California that the foregoing paragraph <br />Is true and correct. <br />WITNESS my hand and official seal. <br />Signature <br />Signature of Notary Public <br />Place Notary Seal Above <br />OPTIONAL <br />Though this section Is optional, completing this information can deter alteration of the document or <br />fraudulent reattachment of this form to an unintended document <br />Description of Attached Document - <br />litle or Type of Document: Co(2rr_irerctkl- s--c_ck_Jl- <br />Document Date: tl2 _\ C\ Number of Pages: <br />Signer(s) Other Than Named Above; I'l - <br />Capacity(ies) Claimed by Signer(s) <br />Signer's Name: <br />o Corporate Officer - Title(s): <br />o Partner -0 Umited 0 General <br />O Individual 0 Attorney in Fact <br />o Trustee 0 Guardian or Conservator <br />o Other:. <br />Signer Is Representing: <br />Signer's Name:__________________________ <br />o Corporate Officer - Title(s): <br />El Partner -0 Umited 0 General <br />O Individual 0 Attorney in Fact <br />o Trustee 0 Guardian or Conservator <br />o Other: <br />Signer Is Representing:
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