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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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CHRISMAN
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34243
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3500 - Local Oversight Program
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PR0544502
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/29/2019 5:06:53 PM
Creation date
5/29/2019 4:53:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0544502
PE
3528
FACILITY_ID
FA0003290
FACILITY_NAME
COUNTRY MART GAS & FOOD
STREET_NUMBER
34243
Direction
S
STREET_NAME
CHRISMAN
STREET_TYPE
RD
City
TRACY
Zip
95304-9334
APN
25318004
CURRENT_STATUS
02
SITE_LOCATION
34243 S CHRISMAN RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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P 293 132 1012 <br /> .Receipt for x <br /> Certifie'dM8 ,1 79,95 <br /> No Insurance Coverage Provided <br /> UNIT EO STRTER Do not use for International Mail <br /> VOSTA-RVI E <br /> (See Reverse) <br /> SenttopUSHPINDER SINGH <br /> PIP"NTRY MART TEXACO <br /> 34243 CHRismAN RD <br /> ynd�ikode 95376 <br /> Postage I,�H� $ .32 <br /> Certified Fee <br /> 1.00 <br /> Speciai Delivery Fee <br /> Restricted Delivery Fee <br /> Return Receipt Showing <br /> 11) to Whom&Date Delivered 1 00 <br /> Return Receipt Showing to Whom, <br /> C Date,and Addressee's Address <br /> TOTAL Postage $ <br /> &Fees 2.32 <br /> Postmark or Date <br /> 00M <br /> E <br /> `o <br /> LL <br /> a <br /> Compete ite a 1 ser - -.„-- _yish to receive the <br /> Complete it <br /> tow IloWing sery ces (for an extra m <br /> • Print your name and add as o the r erse of this for so that we can fee): AN 0 egg > <br /> 4) return this card to you. m <br /> • Attach this fcrm to the front of the mailpiece,or on the back if space 1. Addressee's Address U) <br /> "Aba�loes not permit. C <br /> m "• Write"Return Receipt Requestedon the mailpiece below the article number. <br /> t 2. ❑ Restricted Delivery •� <br /> •' • The Return Receipt will show to whom the article was delivered and the date v <br /> c delivered. Consult postmaster for fee. 0 <br /> •0 3. Article Addressed to: 4a. Article Number <br /> d P 293 132 102 <br /> a PUSHPINDER SINGH 4b. Service Type <br /> E COUNTRY MART TEXACO ❑ Registered ❑ Insured °C <br /> 0 <br /> 34243 CHRISMAN RD X] Certified ❑ COD 5 <br /> y <br /> Receipt for <br /> TRACY CA 95376 ❑ Express Mail ❑ Return <br /> Merchandise <br /> O <br /> Cr <br /> 7. Date of Delivery �� '• <br /> f -- o <br /> T <br /> I t Addr l--— — 8. Addres e's Address(Only if requested xg and fe is 'd) <br /> t <br /> 6. Sign ture (Agent) ~ <br /> >o- PS Form 3811, December 1991 *U.S.GPO:1993-352-714 ME TIC RETURN RECEIPT <br /> H <br />
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