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3500 - Local Oversight Program
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PR0544430
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/7/2019 2:20:17 PM
Creation date
5/7/2019 2:07:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0544430
PE
3526
FACILITY_ID
FA0005370
FACILITY_NAME
PARMAR TEXACO
STREET_NUMBER
521
Direction
N
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
521 N CHEROKEE LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Page 2 <br /> SITE CODE: 1324 <br /> SITE NAME: PARMAR TEXACO <br /> 521 N CHEROKEE LN Z 187 935 899 <br /> LODI CA 95240 USP s 0 _�t <br /> Rece;l for Certified Mail <br /> RESPONSIBLE PARTY(IES): NoInsurance Coverage Frovided, <br /> SALEEM KHAN MOHAMMAD JA14FEL <br /> 118 SWAIN DR 521 N CHEROKEE <br /> LODI CA 95240-6217 LODI CA 95240 <br /> MOHAMMAD JAMEEL MAY 2 01999 <br /> 521 N CHEROKEE LN <br /> LODI CA 95240 0TOTALPOWa <br /> ivery Fee <br /> elivery Fee <br /> CARL YEARING m <br /> on Returneipt Showing to <br /> 1062 RODEO RD = te Delivered <br /> PEBBLE BEACH CA 93953 a <br /> Return nAdddroess <br /> 0 <br /> i0 tage 8 Fees $ <br /> € Posu'grkor Date <br /> 0 <br /> LL <br /> N <br /> a <br /> DE I also wish to receive the <br /> e Complete nems t arW/or 2 for a oat cs following services(for an <br /> .� •Complete nems 3,4a,and 4b. <br /> • <br /> Print your name and address on re r this rm the c um this extra f <br /> CBM to yyou not 1.❑I Y9W� s <br /> •Cam t Mis loan to the front Of the meilpiace,or on the bac <br /> ' perms. /�0 r 2.❑ Restricted Delivery rn <br /> s write'Retum Receipt Requestetl"on the mailpiece below y�e <br /> •The Retum Receipt will show to whom the article was deli f_ t to Consult postmaster for fee. $ <br /> delivered. <br /> € I4 A c b �5S5—' <br /> MOHAMMAD JAMEEL 4b.Service Type <br /> 521 N CHEROKEE ertitied <br /> E ❑ Registered <br /> LODI CA 95240 Insured <br /> ❑ Express Mail c <br /> ❑ Return Receipt for Merchandise ❑ COD <br /> 7. Date 9f Dellve C <br /> 5. Received By: (Print Name) 8.Addressee's A resst(Only it requested <br /> and fee is pa' g <br /> 6. Signature: (Addressee or Agent) <br /> X b J <br /> 9 PS Form 3811,December 1994 102595-9e-s-o229 Domestic Return Receipt <br />
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