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SU0004170
Environmental Health - Public
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2600 - Land Use Program
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QX-84-0010
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SU0004170
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Entry Properties
Last modified
10/27/2020 5:03:03 PM
Creation date
9/6/2019 9:55:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0004170
FACILITY_NAME
QX-84-0010
STREET_NUMBER
29293
Direction
S
STREET_NAME
MACARTHUR
STREET_TYPE
DR
City
TRACY
ENTERED_DATE
5/12/2004 12:00:00 AM
SITE_LOCATION
29293 S MACARTHUR DR
RECEIVED_DATE
2/12/1993 12:00:00 AM
QC Status
Approved
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Supplemental fields
FilePath
\MIGRATIONS\M\MACARTHUR\29293\QX-84-10\SU0004170\REV APPL.PDF
Tags
EHD - Public
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J <br /> Page 3 of 3 <br /> CA Mine 10 s 91-39-0006 pectamation Band Incroasa/Decraase Rider <br /> Permit No. EP-84-10 <br /> Bond No. 106509 <br /> n,ur e-t['1y1E�1T OF PE>aM1TCEE <br /> State of California; fornia <br /> S-- <br /> County <br /> SCounty of Sacramento <br /> On this 5th of Sep in the year �a1 before me, Vircrinia M Halstezt�ud <br /> , <br /> Notaryv ppublic <br /> eared John B Sandman , perso�tallY <br /> (name and quality of officer), personallyapp . <br /> sat+e#ac+taah-e'r4deAQ*)-to be the persorl430 <br /> known to Me rtcr�rovEd Ta m�Q^ <br /> whose nameEi ;,MK subscribed to the within instrument <br /> te and c acknowledged <br /> now edge that he that <br /> hel14IX3V executed the same in hrument thR <br /> hispt3��fQ[Qt"signatureW on the instrument the persons or the entity upon behalf of which <br /> the personal acted, executed the instrument. <br /> VIRGINIA A HALSTENRUD <br /> WITNESS my hand and official seat. TA; comm;sslon01i9a347 <br /> Notay Public-co11fomia s <br /> L.S. soc omento Courny <br /> MyCanm E0W Oct 11,2M2 <br /> Not 's Signature 10-11-02 <br /> My Commission Expires. <br /> .n cnrMFNT tJF SURETY <br /> State of CALIFORNIA <br /> 55. <br /> County of SACRAMENTO <br /> On this 1ST of SEPTEMBERin the year ST <br /> 2000 before me, CHRISTINA FOER NOTA_RRYPUBLIC <br /> KATHY RANGEL personally <br /> (name and quality of officer), personally appearedto be the personfed <br /> known to me (d"MW" 7� <br /> whose name6d is$am subscribed to the within instrument and acknowledged to me that <br /> hedshe/tbrayt executed the same in hWherltk c authorized capacity('ees), and that by <br /> hdlher/ sisnaturetsk on the instrument the person(, or the entity upon behalf of which <br /> the person(:" aced, executed the instrument. <br /> WITNESS my hand and official seal. CHRISTINA FOSTER <br /> h Commission#1234196 <br /> (t n_ 1 p lA(J L,S, `_ •ti:.> :'s Notary Pubric-Caiifomia <br /> ::• ._.� scecmento County <br /> Notary's Signature r.*.,n=:m,^. SrZ10.2m3 <br /> 9-10-03 <br /> My Commission Expires: <br /> -_..- ..a_ <br /> NOTE: Please identify the agent acting on behalf of the surety, if applicable_ <br /> AGENT ABD INSURANCE SERVICES <br /> PHONE (916)485-4500 <br /> ADORESS 960 FULTON AVENUE, SACRAMENTO, CA 95825 <br />
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