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SITE INFORMATION AND CORRESPONDENCE
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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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224,364 484 <br /> ATTN EXECUTIVE OFFICER <br /> CENTRAL VALLEY REGIONAL <br /> WATER QUALITY CONTROL BORAD <br /> 3443 ROUTIER RD STE A <br /> SACRAMENTO CA 95827-3098 <br /> APR 2 8 1998 <br /> WReWmRec*qmNj0wn0M, <br /> $ <br /> Fee <br /> elivery Fee <br /> d Delivery Fee <br /> rn eceipt Showing to Date Deliveredut StatvN to Wfam,dressee's Address <br /> O <br /> Q TOTAL Postage h Fees Is <br /> C') Postmark or date <br /> $E let items and/or 2 for additional services. I also Wish t0 receive the <br /> 'm ■Complete items 3,4a,and 4b. following services(for an <br /> 0 sprint your name and address on the rev for at �can return this extrPA <br /> card to you. St�� <br /> ■Attach this form to the front of the 1. dres es ress <br /> 4) permit. <br /> d ■Wnte'Retum Receipt Requested'on the mailpiece elow the article number. 2. ❑ Restricted Delivery N <br /> r ■The Return Receipt will show to whom the article as delivered and the date a <br /> delivered. Consult postmaster for fee. <br /> � 4a. rtic�e�N7u/�ber�j� <br /> ATTN EXECUTIVE OFFICER .C�—ohC T`\. <br /> CENTRAL VALLEY REGIONAL 4b.Service Type <br /> WATER QUALITY CONTROL BORAD ❑ Registered L Certified <br /> 3443 ROUTIER RD STE A f❑ Express Mail ❑ Insured 'w <br /> SACRAMENTO CA 95827-3098 ❑ Return Receipt for Merchandise ❑ COD <br /> 0 <br /> `7.Date of Delivery o <br /> i <br /> 5.Rece' d y:,(PrintName) <br /> T 8.Addres s Address(Only if requested <br /> Ic and fee is d) <br /> g 6 Sig ( r s or gent> �y <br /> w PS Form 3811, Decemb 1994 Domestic Return Receipt <br />
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