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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0009012
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Last modified
11/1/2018 9:32:15 PM
Creation date
11/1/2018 11:56:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0009012
PE
2960
FACILITY_ID
FA0004532
FACILITY_NAME
FRMR KEARNEY-KPF FACILITY
STREET_NUMBER
1624
Direction
E
STREET_NAME
ALPINE
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
11708006-09
CURRENT_STATUS
01
SITE_LOCATION
1624 E ALPINE AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <br /> State of California <br /> County of San Joaauin <br /> On January I I. 2005 before me,N Furtado.Notary Public <br /> DATE NAME M E OF OFFKEF' <br /> personally appeared Chri5Wphcr Bennitt <br /> NAMFAS)OF SW.NE&S) <br /> ❑ Personally(mown to me OR 0 proved to me on the basis of satisfactory evidence to be <br /> the person(s) whose name(s) isiiaPt subscribed to the <br /> within instrument and acknowledge to. me that <br /> he�;6ey executed the same in hisQFcr/lkefr authorized <br /> wczj-( <br /> RJRTgDO capacity(ies), and that by hisGher/ihelf signature(s)on the <br /> mw 1 instrument the person(s), or the entity upon behalf of <br /> PukAQUIN COUNTY which the person(s)acted,executed the instrument. <br /> EV.AUG.24,20% <br /> WITNE yrand official sear] <br /> �/ 1 \ f <br /> swT:An:aE or NorARr <br /> OPTIONAL <br /> Though the data below is not required by law, it may prove valuable to persons mlying on the document <br /> and could prevent fraudulent reattachment of this form <br /> CAPACITY CLAIMED BY SIGNED DESCRIPTION OF ATTACHED DOCUMENT <br /> ❑ INDIVIDUAL Covenant to Restrict Use of Property <br /> 0 CORPORATEOFFICER TITLE OR T)-PE OF DOCUMENT <br /> Resident <br /> TULLIS) <br /> ❑ PARTNER(S) ❑ LIMITED <br /> ❑ GENERAL NUMBER OF PAGES <br /> ❑ ATTORNEY-IN-FACE <br /> ❑ TRUSTEE(S) DATE OF DOCUMENT <br /> ❑ GUARDIAN/CONSERVATOR <br /> ❑ OTHER: <br /> SIGNER(S)OTHER THAN NA IF A8OVE <br /> SIGNER IS REPRESENTING: <br />
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