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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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7(T <br /> lete items 1,2,and 3.Also complete A. Sign ure <br /> if Restricted Delivery is desired. ❑A nt <br /> your name and address on the reverse X <br /> t Addressee <br /> '3fQ fi �tUrrt the card to you. g, a ted Name) C. Date of Delivery <br /> thls,G d f that;ldil&i�pe, <br /> the frontrf space permits. �tYY�t�f lL 1�� <br /> Atldressed to: D. Is delivery address different item 1? ❑Yes <br /> If YES,enter delivery address below: ❑No <br /> KAREN PETRYNA Z 2005 <br /> SHELL OIL PRODUCTS <br /> NTON AVE 3. Service Type <br /> 20945 S WILNI SPS <br /> CARSON }it Certified Mail press Mail <br /> CA 90$10 egistered 0 Return Receipt for Merchandise <br /> ❑ Insured Mail 0 C.O.D. <br /> 4. Restricted Delivery?(F_xtra Fee) ❑Yes <br /> u, s7003 3110 0003 5254 4378r from seMce/ab n <br /> PS Form 3$11,February 2004 Domestic Return Recelob -JA A __ _ (_�.._._ <br />
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