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COMPLIANCE INFO_2014 - 2018
Environmental Health - Public
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EHD Program Facility Records by Street Name
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CAPITOL
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6421
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2300 - Underground Storage Tank Program
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PR0231706
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COMPLIANCE INFO_2014 - 2018
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Last modified
6/11/2019 2:30:29 PM
Creation date
4/10/2019 4:46:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2014 - 2018
RECORD_ID
PR0231706
PE
2361
FACILITY_ID
FA0000485
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95242
APN
05532024
CURRENT_STATUS
01
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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RECEIVED <br /> nFF ` 8 2017 <br /> A notary public or other officer completing this certificate verifies only the identity of the individual' <br /> who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or <br /> validity of that document. <br /> STATE OF CALIFORNIA ) <br /> )ss. <br /> COUNTY OF SAN JOAQUIN ) <br /> On March 8,2017,before me,DARKEN CORDANO, a Notary Public,personally appeared <br /> SYBLE BOKIDES,who proved to me on the basis of satisfactory evidence to be the person(') <br /> whose name(s)is/are subscribed to the within instrument and acknowledged to me that <br /> Wshe/t1wy executed the same in bWher/their authorized capacity(jod),and that by big/her/t1}eir <br /> signature(z-)on the instrument the person(s),or the entity upon behalf of which the person( <br /> acted,executed the instrument. <br /> I certify under PENALTY OF PERJURY 61111"C <br /> under the laws of the State of Califomia that :�Q-���9 0 M�y�'; <br /> the foregoing paragraph is true and correct ; O��oSARv Pc01 <br /> WITNESS my hand and official seal. L) N <br /> '•FXprREs�.�' <br /> SignatureD (Seal) <br /> Order:0125001683 Page 2 of 2 Requested By:rtudor,Printed:3117/2017 8:35 AM <br /> Doc:CASANJ:2017 00027657 <br />
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