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COMPLIANCE INFO_2013-2016
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0232397
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COMPLIANCE INFO_2013-2016
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Entry Properties
Last modified
10/18/2023 9:06:11 AM
Creation date
6/3/2020 9:56:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2013-2016
RECORD_ID
PR0232397
PE
2361
FACILITY_ID
FA0003978
FACILITY_NAME
KAISER FOUNDATION - MANTECA
STREET_NUMBER
1777
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95337
APN
20018034
CURRENT_STATUS
01
SITE_LOCATION
1777 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
KBlackwell
Supplemental fields
FilePath
\MIGRATIONS\Y\YOSEMITE\1777\PR0232397\MODIFICATION APPROVAL PLAN 2014.PDF
QuestysFileName
MODIFICATION APPROVAL PLAN 2014
QuestysRecordDate
11/16/2016 4:57:02 PM
QuestysRecordID
3258884
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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RECEIVED <br /> AUG <br /> CALIFORNIAENVI ON T L HEALTH <br /> T <br /> State of California <br /> County of <br /> On Q before me, U. Jk_0_ . (nn,,i"rx, WJcl,,NC <br /> Dale Nere lns rt Nale e anilTolle of the Of icer <br /> personally appeared + ~� <br /> Names)of Signers) <br /> t <br /> who proved to me on the basis of satisfactory <br /> evidence to be the person(s) whose name(s) is/are <br /> subscribed to the within instrument and acknowledged <br /> to me that he/she/they executed the same in <br /> his/her/their authorized capacity(ies), and that by <br /> his/her/their signature(s) on the instrument the <br /> person(s), or the entity upon behalf of which the <br /> person(s) acted, executed the instrument. <br /> JUDITH C.MONTOYA <br /> 9; Are Contilission*1987802 1 certify under PENALTY OF PERJURY under the <br /> Notary Public-California laws of the State of California that the foregoing <br /> Zia n County paragraph is true and correct. <br /> Comm.My lies Aut3O,2016 <br /> WITNESS my hand and official seal) <br /> Signature: <br /> Placa Notary Seal AboveSi n2Wra a Notary Pu i <br /> OPTIONAL <br /> Though the information below is not required by taw,it may prove valuable to persons relying on the document <br /> and could prevent fraudulent removal and reattachment of this form to another document, <br /> Description of Attached Locum t � <br /> Title or Type of Document: .f L% f t o C I ly� C'f - 16, 1 _ <br /> Document Date: 037 L-/ Number of Pages: <br /> Signer(s)Other Than Named Above: <br /> Capacity(ies) Claimed by Signer s) <br /> Signer's Name: _ ` _ t° Signer's Name: <br /> Corporate Officer — Title{s}: �- - _._ Corporate Officer —Title{s}: <br /> :i individual 01 Individual <br /> I Partner— , Limited General Top of ttrluttb here i- Partner—f Limited .-i General ,p at lhurnalhere <br /> Cl Attorney in Fact Ej Attorney in Fact <br /> 1 Trustee Trustee <br /> Guardian or Conservator Guardian or Conservator <br /> :_E Other: - E Other: <br /> Signer Is Representing: Signer Is Representing: <br /> ,t.2010 National Notary Association•NallonalNotary,org-f-800-US NOTARY(t-600•$70-6827) Item 05907 <br />
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