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SU0008267
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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PA-1000108
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SU0008267
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Entry Properties
Last modified
5/7/2020 11:33:25 AM
Creation date
9/8/2019 12:41:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0008267
PE
2690
FACILITY_NAME
PA-1000108
STREET_NUMBER
5199
Direction
E
STREET_NAME
PELTIER
STREET_TYPE
RD
City
ACAMPO
APN
00518035 58 59
ENTERED_DATE
5/24/2010 12:00:00 AM
SITE_LOCATION
5199 E PELTIER RD
RECEIVED_DATE
5/24/2010 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\P\PELTIER\5199\PA-1000108\SU0008267\APPL.PDF \MIGRATIONS\P\PELTIER\5199\PA-1000108\SU0008267\CDD OK.PDF \MIGRATIONS\P\PELTIER\5199\PA-1000108\SU0008267\EH COND.PDF \MIGRATIONS\P\PELTIER\5199\PA-1000108\SU0008267\EH PERM.PDF
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EHD - Public
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i CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <br /> i <br /> State of California <br /> County of V <br /> _ L <br /> Onbefore me, � , <br /> Datel i Here <br /> ,Insert <br /> /Name and Title of the Officer <br /> personally appeared am`k la <br /> Name(s 9'Signer(s) <br /> who proved to me on the basis of satisfactory evidence to <br /> be the person(s) whose name(s),ifslare subscribed to the <br /> within instrument and acknowledged to me that <br /> I� lasleiaelthey executed the same in authorized <br /> i CAROL S.BECKMAN capacity(ies), and that by Ni-Ow/their signature(s) on the <br /> conrnplsa e#1859412 instrument the person(s), or the entity upon behalf of <br /> Notary Pubk-CaRkwoia which the person(s) acted, executed the instrument. <br /> San Joaquin Com <br /> I comm.El tresAu 25'291$ 1 certify under PENALTY OF PERJURY under the laws <br /> of the State of California that the foregoing paragraph is <br /> true and correct. <br /> WITNESS my hand an off/i ial seal. . <br /> Signature <br /> SCJ - <br /> Place Notary Seal Above Signature of notary Public <br /> OPTIONAL <br /> Though the information below is not required by taw, it may prove valuable to persons retying on the document <br /> and could prevent fraudulent removal and reattachment of this form to another document. <br /> Description of Attached Document , <br /> Title or Type of Document: QQ) � <br /> 1Oksvo5utt - <br /> Document Date: Number of Pages: <br /> Signer(s) Other Than Named Above: <br /> Capacity(ies) Claimed.by Signer(s) <br /> Signers Name: Signers Name: <br /> ❑ Individual [].Individual <br /> ❑ Corporate Officer—Title(s): ❑Corporate Officer=Title(s): <br /> ❑ Partner—❑ Limited ❑ General _ _ ❑ Partner—❑ Limited ❑ GeneralWIND <br /> _ <br /> ❑ Attorney in Fact • ❑Attorney in t=act • ,.,�+ <br /> © Trustee Top of thumb here ❑Trustee Top of thumb here <br /> ❑ Guardian or Conservator ❑Guardian or Conservator t�+' <br /> ❑ Other: ❑Other: <br /> Signer Is Representing: Signer Is Representing: .1 <br /> A=j'�+fVY <br /> 7 02007 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,GA 91 31 3-24 02•www.NationalNotary.org Item#5907 Reorder:Call Toll-Free 1-800-876{827 ` �° <br />
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