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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BENJAMIN HOLT
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3011
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2900 - Site Mitigation Program
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PR0530063
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
2/6/2019 3:55:34 PM
Creation date
2/6/2019 3:42:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0530063
PE
2957
FACILITY_ID
FA0019769
FACILITY_NAME
FORMER SHELL GAS STATION
STREET_NUMBER
3011
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95219
APN
10018010
CURRENT_STATUS
01
SITE_LOCATION
3011 W BENJAMIN HOLT DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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■ Complete items 1,2,and 3.Also complete <br /> item 4 if RRessttricted Delivery is desired. ature <br /> ■ Print y. name a d d <br /> so that vJlii9 r93W'r Fon the reverse �t � <br /> ■ Attach this ca to You. �+r�ant <br /> to the back of the mail iece, B• Re ❑Addressee <br /> or on the front if space UAPIi , Y(Printed Name <br /> Permits.. N� a• ) C. Date of Delivery <br /> I. Article Addre3sed to: ,- <br /> D. Is d <br /> If Y dalry di ss ed ? 0 Yes <br /> 0 No <br /> ATTN EXECUTIVE AUG � 1 2000 <br /> CALIFORNIA REGIONAL OFFICER <br /> CONTROL, BOARD ENVIROMMENT HEALTH <br /> 11020 SIIN CENTER DR 4IIALITY <br /> 5 Ice <br /> RAD7CH0 CORDOV #200 eisted Matl ❑Express Mail <br /> A CA 9 5 6�0-6114 /�Registered❑Insured 0 Return Receipt for Merchandise <br /> Mail ❑C.O.D. <br /> 2• Article Numtrer <br /> Restricted Delivery?(Expa Fee) <br /> (>ans/artmma 7004 2510 0004 3876 0Y� <br /> PS Form 3811,Febru5381 <br /> ary 2004 <br /> Domestic Return Receipt <br /> / 1 4. 1 � 1a <br />
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