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COMPLIANCE INFO_2008-PRESENT
Environmental Health - Public
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EHD Program Facility Records by Street Name
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1085
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2900 - Site Mitigation Program
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PR0545446
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COMPLIANCE INFO_2008-PRESENT
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Entry Properties
Last modified
3/3/2020 3:34:46 PM
Creation date
3/3/2020 2:23:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
FileName_PostFix
2008-PRESENT
RECORD_ID
PR0545446
PE
2961
FACILITY_ID
FA0019341
FACILITY_NAME
GORDON PROPERTY
STREET_NUMBER
1085
Direction
S
STREET_NAME
UNION
STREET_TYPE
RD
City
MANTECA
Zip
95337
CURRENT_STATUS
02
SITE_LOCATION
1085 S UNION RD
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE§8202 <br /> i <br /> See Attached Document(Notary to cross out lines 1-6 below) i <br /> ❑See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) i <br /> --------- ----------------------------------------------- <br /> 2----- --------------------- <br /> 3--------------------------------- ——————————————————————--— <br /> 4-------------------------------------------- -------------- <br /> 5-------------------- ------------------ <br /> 6 , a <br /> Signature of Document Signer No.1 Signature of Document Signer No.2(if any) <br /> State of CaliforniaSubscribed and sworn to (or affirmed) before me <br /> County of LWM_&_M&ak on this llrq day of AMOIJ31 20/-3, <br /> by Date nth Year <br /> (1) �� i_ <br /> Name of Signer <br /> I� <br /> proved to me on the basis of satisfactory evidence <br /> THERESA M.VIGIL to be the person who appeared before me (.) (,) <br /> Commission*1962796 (and <br /> Notary Public-Califonmia <br /> Sacramento County 3 (2) <br /> OMComm.Expires Dec 5,2015 Name of Signer <br /> proved to me the basis of satisfactory evidence <br /> to be the toe o a peared b fore me.) <br /> Signature <br /> Place Notary Seal Above gn ur of blic <br /> OPTIONAL <br /> Though the information below is not required by law,it may prove valuable Top of thumb here Top of thumb here <br /> to persons relying on the document and could prevent fraudulent removal <br /> and reattachment of this form to another document. <br /> Further Description of Any Attached Document fes/ <br /> Title or Type of Document:/Aka <br /> F�Z <br /> Document Date: S �ONumber of Pages: <br /> Signer(s)Other Than Named Above: 1201V 01V C <br /> 0 2010 National Notary Association-NallcnalNotary.org•1.800-US NOTARY(1-800-876.6827) Item#5910 <br />
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