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SU0003895 SSCRPT
Environmental Health - Public
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2600 - Land Use Program
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PA-0300498
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SU0003895 SSCRPT
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Entry Properties
Last modified
5/7/2020 11:30:16 AM
Creation date
9/9/2019 11:03:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0003895
PE
2622
FACILITY_NAME
PA-0300498
STREET_NUMBER
35088
Direction
S
STREET_NAME
WELTY
STREET_TYPE
RD
City
TRACY
ENTERED_DATE
5/11/2004 12:00:00 AM
SITE_LOCATION
35088 S WELTY RD
RECEIVED_DATE
9/26/2003 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\W\WELTY\35088\PA-0300498\SU0003895\SSC RPT.PDF
Tags
EHD - Public
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Sent By: Begetti 6-0s. ; 935 2896; Aug-25-03 1 :43PM; Page 14114 <br /> eeC oi�atl: B/28!0� 9:33AIA; 209 3150 4228 -> BOO"" "' u . s.. • ' <br /> FRS MOR 6 w.rorty enia l pHoNE NCI. 209 369 4228 'Rug. 25 2003 08:29PC'I P14 <br /> NQA <br /> fT��IROt�nnuy'rni 1(1RNtfMRFR <br /> PROPERTY LCx'A'I'1gNt <br /> ENDORSEMENTS <br /> PART 1 <br /> As the User of the Phase 1 ErIvironment I Assessment being prepared for the property(or the duly <br /> authorized representative of such user),I have specific lmowledge of the questions posed in PART <br /> 1 of this Questiottnaim regarding the proparty, and hereby certify to and for the benefit of <br /> Leoder/purcheser that to the best of my knowledge,information and belief the information disclosed <br /> above is trw and correct. <br /> User or Client's name v <br /> i <br /> Signature and e <br /> V <br /> i <br /> Title <br /> PART 2 <br /> At the present owner of the property or as an officer or general pat=&,of the present owner of the <br /> property (or the duly authorized represantabvc of such owner). T atri famiSar with all of the <br /> operations presently conducted on the property, and hereby wrtifjt to and far the benefit of <br /> [,endeV?=haser that to ilic best of my knowledge,information and belief the i¢rfbrmation disclosed <br /> above is true and correcctQt. <br /> rlyl� Uaf l�111 =- <br /> /Owwrer'a or Keyy bile rvia;w15a o ua...� <br /> Signature and e <br /> Title <br /> you have any questions about thn questionnaire,ple"e contact P:;n Anwfev _a((209)367-3701 11 1� <br />
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