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SU0014668
EnvironmentalHealth
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2600 - Land Use Program
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OX-91-4
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SU0014668
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Entry Properties
Last modified
11/9/2022 4:12:37 PM
Creation date
7/7/2022 1:13:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0014668
PE
2600
FACILITY_NAME
OX-91-4
STREET_NUMBER
26255
Direction
E
STREET_NAME
BRANDT
STREET_TYPE
RD
City
LODI
APN
02324001
ENTERED_DATE
12/21/2021 12:00:00 AM
SITE_LOCATION
26255 E BRANDT RD
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> Legal Owner (s ) (All owners must sign as their names appear on the <br /> deed. ) , <br /> Corporate Officer ( s ) empowered to sign for the corporation, <br /> LJ Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> and that the foregoing is true and correct . <br /> TIERRA RESOURCES, INC. <br /> (Signature ) ( Date ) <br /> by: <br /> J,/ / E g— �, <br /> (Si ture ) ( Date ) <br /> Edward J. Questo resid <br /> by: t Z 2 �- - / <br /> (Si ature ( Date ) <br /> Frances Questo,, ce-President <br /> b � � v�C�, <br /> y� (Signature ) ( Date ) <br /> Don Questo, Vice-President <br /> Application Form <br /> Quarry Excavation - 6 - ( 3/89 ) <br />
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