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SITE INFORMATION AND CORRESPONDENCE FILE 2
EnvironmentalHealth
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COUNTRY CLUB
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2103
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3500 - Local Oversight Program
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PR0544591
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SITE INFORMATION AND CORRESPONDENCE FILE 2
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Entry Properties
Last modified
6/21/2019 7:17:12 PM
Creation date
6/21/2019 11:37:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 2
RECORD_ID
PR0544591
PE
3526
FACILITY_ID
FA0005220
FACILITY_NAME
CHEVRON #9-4054
STREET_NUMBER
2103
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12308029
CURRENT_STATUS
02
SITE_LOCATION
2103 COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION <br /> ON <br /> ■ Complete items 1,2,and 3.Also complete A. Signatu <br /> item 4 If Restricted Delivery is desired. X ❑Agent <br /> ■ Print your nameandaddress on the reverse ❑Addressee <br /> so that we�Fl�tl�e= you.lp B. Rec 'ved y(Printed Name) C. Date of Delivery <br /> ■ Attach this car to mm the fifi ftryv /� •%0'c"N <br /> or on the front if space permits. U IV 1. +�J <br /> D. Is delivery address differentRem 1? ❑Yes <br /> 1. Article Add�:ssetl to: If YES,enter delivery addres below: ❑No <br /> n <br /> BOB BERBERIAN <br /> BERBERIAN FAMILY TRUST 3. .SferviceType <br /> 2021 W MARCH r mSTE A Q{Certified Mail 13 Express Mail <br /> STOC"KTON CA 95207 �j Registered ❑ Return Receipt for Merchandise <br /> ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑yes <br /> . Article Number <br /> (Transfer fil sewice label 7003 3110 0003 5254 3623 yds <br /> Form 3$11,February 2004 Domestic Return Receq�fp� z/z__ s 540 <br /> • � C-dL!/1 <br /> n <br /> a <br /> rn •. <br /> m <br /> Ln <br /> �r1 ea,Y ami va 0 y m <br /> m rij <br /> POs.age $ Q¢ `o Y Z E $ Z <br /> O Certified Fee ❑ ❑ 00 _ ❑ <br /> r <br /> O RRedeye Fee Postmark (7 p <br /> (ErMorfamesemem RequlreM i <br /> 0 _ a <br /> Restricted Delivery Fee Here E <br /> E n rvi E <br /> � (Entlorsement Required) <br /> m <br /> mV g E0 <br /> Total Poser BOB BERBERIAN 2 D < of ¢ v <br /> ML <br /> BERBERIAN FAMILY TRUST ° m U ❑ ❑ ❑ a <br /> 2021 W MARCH I.N STE A _ m <br /> T D O O N <br /> r` STOCKTON CA 95207 '•-- a � I- tm j <br /> a w`C I>a z g 'm 'm v ru <br /> u'1 .m <br /> d K m d ❑ a m E <br /> O <br /> 7 O <br /> r 9 <br /> o a, <br /> 13 <br /> .11 <br /> a1 H paq a <br /> M - • d ~ fY� E <br /> _ " OI ry m & <br /> ru AG~ g d 'om 001 M <br /> q �J ° <br /> Postage $ <br /> --'--- _tea' � CS IZI <br /> �ob Q o U <br /> M <br /> Certified Fee GO4��0 D > 10 a vi <br /> F pd ~ o <br /> p Return Reciept.F .S5 by Poeknok @t I:$t m ."1. W N <br /> v <br /> (Entlorepment Reqs G o/ F1ere ai m L1 z <br /> r3 Resti'ded Dolr G,�y�Q p��4,�` y ° P4 .4 <br /> r-9 (Endorsemer' `�" G 0rq '�" <br /> M G, 'U� G :e ar'i � coo <br /> M <br /> Total��.��,p_O_pv HCl • 3 Z o U PP44 E 2 <br /> C3 ti as 0.mL" m pa O Z <br /> 0 ` �; O _ L U C _ m y <br /> EEc « mo o O O ° C <br /> f` She, b U«a H Q `o rQ C7 to p <br /> y .._............................................. ■ ■ ■ t tl <br /> orPo <br /> a. <br />
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