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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0518600
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
12/7/2018 10:53:10 AM
Creation date
12/7/2018 10:30:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0518600
PE
2960
FACILITY_ID
FA0013996
FACILITY_NAME
CROP PRODUCTION SERVICES
STREET_NUMBER
1905
Direction
N
STREET_NAME
BROADWAY
City
STOCKTON
Zip
95205
APN
14315004
CURRENT_STATUS
01
SITE_LOCATION
1905 N BROADWAY
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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All-Purpose <br /> Certificate of Acknowledgement MML 4to24-B <br /> State of California <br /> County of Los Angeles <br /> On September 10, 1998 before.me, Evelyn Denihan, Notary Public <br /> Date NAME,TITLE OF OFFICER•E.r.,-JANE DOE,NOTARY PUBLIC: <br /> personally appeared Cesar F. Javier <br /> NAMES)OF SIGNERS) <br /> X personally known to me-OR ❑ -proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) <br /> is/am subscribed to the within instrument and acknowledged <br /> to me that he/shelthey executed the same in his/her/their <br /> authorized rapactiy(ics), and that by his/her/their signature(s) <br /> on the instrument the pemon(s), or the entity upon behalf of <br /> rs which the person(s)acted,executed the instrument. <br /> EVEIYN OENINAN -p <br /> Comm.#1045298 $ <br /> NOTARY Pusuc-CAWOtL1pp ` Wime my handsdillri Iseal. <br /> Loa Maetes coamy .� <br /> 11 MyComm.uWesNor 9a <br /> SIGNATURE OF NOTARY <br /> Though the data below is not required by law, it may prove valuable to persons relying on the document and prevent fraudulent <br /> reattachment of this form. <br /> CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT(S) <br /> ❑ Individual(s) <br /> ❑ Corporate <br /> ❑ Office(s) <br /> TITLE(s) <br /> ❑ Partner(s) <br /> X Attorney-in-fact <br /> ❑ Trustee(s) <br /> ❑ Subscribing witness <br /> ❑ Guardian/Conservator <br /> ❑ Other: <br /> SIGNER IS REPRESENTING: <br /> NAME OF PMONM OR ENTITY(IES) <br /> National Union Fire Insurance Company of Pittsburgh,Pa. <br />
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