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ARCHIVED REPORTS XR0000658
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CAPITOL
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6421
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2900 - Site Mitigation Program
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PR0522496
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ARCHIVED REPORTS XR0000658
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Entry Properties
Last modified
2/15/2019 8:06:41 PM
Creation date
2/15/2019 3:10:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000658
RECORD_ID
PR0522496
PE
2957
FACILITY_ID
FA0015317
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95245
APN
05532024
CURRENT_STATUS
02
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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i <br /> SENDER: <br /> m sComplete Items 1 and/or 2 for additional services. I also wish to receive the <br /> ■Complete Items 3, 4a, and 4b. following services (for an <br /> H ■Print your name and address on the reverse of this form so that we can return this extra fee): <br /> card to you <br /> sAttach this form to the front of the mallpiece, or on the back if space does not 1 ❑ Addressee's Address <br /> L permit. <br /> sZte'Return Receipt Requested'on the madplece below the article number 2 ❑ Restricted Delivery <br /> CsThe Return Receipt will show to whom the article was delivered and the data <br /> delivered Consult postmaster for fee ,.. <br /> o <br /> � 3. Article Addressed to: � C 4a. Article Number <br /> E 4b Service Type <br /> ❑ Registered 15 Certified tt <br /> ❑ Express Mall ❑ Insured S <br /> UJI <br /> f k "i, . ; , r P t �' ��°� ` 'i atum Receipt for Merchandise ❑ COD o <br /> a 7. Date of Delivery 3 <br /> z ° <br /> 5. Received By: (Print Name) 8 Addressee's Address (Only If requested c <br /> and fee is paid) <br /> eel A f� <br /> o6 Slgnatu ( ddress Aganp <br /> a• X <br /> N <br /> P5 Form 3811, December 1994 Domestic Return Receipt <br />
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