Form ID

Publication date

Location of premises

Certificate

Desludging of Stoney Point Sewage Lagoon (Pond #2) know as Contract No. 2, Project No. 04-0008

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Corporation of the Town of Lakeshore
Address of Owner
419 Notre Dame, Belle River, ON N0R 1A0
Name of Contractor
Salcin Haulage Inc.
Address of Contractor
224393 Ostrander Road, Tillsonburg, ON N4G 4H1
Name of Certifier
David Nussey (Operations Manager, OCWA)
Address of Certifier
Belle River-Maidstone Wastewater Treatment Plant, R.R.#3 276

Office to which claim for lien must be given to preserve lien

Manager, Environmental Division, Engineering & Infrastructure Services, Town of Lakeshore, 419 Notre Dame, Belle River, ON N0R 1A0