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SITE INFORMATION AND CORRESPONDENCE FILE 3
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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2575
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2900 - Site Mitigation Program
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PR0541989
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SITE INFORMATION AND CORRESPONDENCE FILE 3
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Last modified
6/21/2019 5:29:52 PM
Creation date
6/21/2019 3:23:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 3
RECORD_ID
PR0541989
PE
2950
FACILITY_ID
FA0024100
FACILITY_NAME
COUNTRY CLUB VALERO
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12302012
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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(Domestic Mail Only; No Insurance Coverage Provided) r <br /> M CERTIFIED <br /> ' MAILTm RECEIPT m <br /> rl - t <br /> a � <br /> m S <br /> Postage a . m Presage <br /> rrl O Cenitled Fr <br /> E3 Certified Fee <br /> E3 �x <br /> E3 Return Reclept Fee Postmark p Return Reclr' f� � Postmark <br /> (Endorsement Required) Here p (EndomamentP Here <br /> RestriotRestricted Delivery Fee •� (Endorsendr <br /> nJ (Endorsement Required) FU <br /> V <br /> (lJ TOP <br /> Total Pr DENIS L BROWN <br /> C3 Sent To SHELL OIL PRODUCTS IIS op rA4 <br /> RUSE - ENVIRONMENTAL SERVICES rSA <br /> - G <br /> oreei, "1 20945 S WILMINTON AVENUE 6 h <br /> PO Ba -rcl-N <br /> 8ih,siai, CARSON CA 90810-1039 <br /> COMPLETEmaul <br /> COMPLETE THIS SECTION ON DELIVERY <br /> SECTION <br /> ■ Complete items 1 , 2, and 3. Also complete A. Signature 0 Agent <br /> item 4 if Restricted Delivery is desired. x ❑ Addressee <br /> ■ Print your name and address on the reverse <br /> so that we =t ,je=p,4to you. B. Received by ( Printed Name) C Date oDelivery <br /> ■ Attach this he mailpiece, <br /> or on the front If space permits. 111RIT im D. Is delivery address different from Nem 17 0 Yes <br /> 1 . Article Addressed to: If YES, enter delivery address below: 0 No <br /> [DR p"WED <br /> DAVID HOOVER L F - , <br /> CALIFORNIA FUEL. SUPPLY INC 3. Se7vlce Type 1. <br /> 587 YGNACTO VALLEY ROAD rtIW Mall El Express Mali <br /> WALNUT CREEK CA 94596 B Reglste6WVlR@91itib6 'hodeip%MrWerohandise <br /> 0 Insured M <br /> 4, Restricted Delivery? (Extra Fee) ❑ Yes <br /> 2. Article Number <br /> (Iransler fore service leba 7003 2260 0003 3185 43.03 _ � JOQ 1 <br /> PS Form 3811 , February 2004 Domestic Return RI 75 �° i ' <br /> i <br /> SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1 , 2, and 3. Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. - 0 Agent <br /> 11111 Print X nt your name and address on the reverse - - 0 Addressee <br /> so that we rrryt♦e op1S�! you. B. Received by Printed Name) C. Date of Delivery <br /> ■ Attach this c t 6$omits, g �eilnieca, <br /> or on the front if space permits. VViv <br /> D. Is I t from it <br /> 17 p Yes <br /> 1 . Article Addressed to: If YES, en r j qj ❑ No <br /> 91 ij� t - <br /> ri <br /> r &/V 1 `� 20105 <br /> DENIES L BROWN <br /> SHELL OIL PRODUCTS US. F �N <br /> HSE ENVIRONMENTAL SERVICES 3�CertiNadMalrRV�fl' reskMeli <br /> 20945 S WILMINTON AVENUE /® Registered 13 Return Receipt for Merchandise <br /> CARSON CA 90810-1039 0 Insured Man 0 C.O.D. <br /> 4, Restricted Delivery? (Extra Fee) ❑ Yes <br /> 2, Article Number 7003 2260 0003 3185 4310 ( �0�� <br /> (nansler hem serI label) <br /> ac cn,m ARl 1 Fahnjnm pnnn Domestic Return Recelot _7 �, 7rr Ia-,�„at sDzs�a� a po <br />
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