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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0503634
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/7/2019 4:40:56 PM
Creation date
5/7/2019 4:15:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0503634
PE
2950
FACILITY_ID
FA0005914
FACILITY_NAME
VICTOR ROAD SHELL
STREET_NUMBER
880
STREET_NAME
VICTOR
STREET_TYPE
RD
City
LODI
Zip
95240
APN
04905032
CURRENT_STATUS
02
SITE_LOCATION
880 VICTOR RD
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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■ Complete items 1,2,and 3.Also complete A. signature <br /> 1-41 <br /> item 4 If Restricted Delivery is desired. X ❑Agent <br /> ■ Print your nos and address on the reverse ❑Addresses <br /> i SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> so that we can return the card to you. R. Received (Printed Name) Dose uf�e very <br /> 11 ■ Attach thiss card to the back of the mailpiece, <br /> ru( or on the front if space permits. D Is delivery ed_ to p Yes <br /> Rill pr�10 <br /> 1. Article Addressed to: ,If YFS,"entertiell dtlress below: �U1 <br /> m - <br /> n <br /> r3 ATTN EXECUTIVE OFFICER <br /> C3 UNDi GROUND STORAGE TANK UNIT s ce Type, {- <br /> C3 11020 UN tc?iTER DR#200 <br /> 0 <br /> RAN 0 0—r.UOVA CA 95670-6114 ❑Regi�red 0� Receipt for Merchandise <br /> C3RE:880 EAST VICTOR RD E3Insured Mail ❑C.O.D. <br /> r, 7010 2780 0000 6637 3291 <br /> 4. Restricted Delivery?Antm -- M Yes <br /> R1 <br /> 2 <br /> 2. ArUGe Number- 78❑ ❑000 6637 3291 _ <br /> 701� __-- <br /> l7 (transfer from service labe0 — — t0259s02-M-t sao <br /> r` Domestic Return Receipt <br /> PS Form 3811,February 2004 <br />
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