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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0543804
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
6/28/2019 2:12:36 PM
Creation date
6/28/2019 1:21:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0543804
PE
2950
FACILITY_ID
FA0024907
FACILITY_NAME
7-ELEVEN STORE #20632
STREET_NUMBER
4627
STREET_NAME
DA VINCI
STREET_TYPE
DR
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
4627 DA VINCI DR
P_LOCATION
01
QC Status
Approved
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Tags
EHD - Public
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f <br /> d SENDER: I also wish to receive the <br /> ■Complete items 1 and/or 2 for additional services. following services for an <br /> h ■Complete items 3,4a,and 4b. g <br /> W ■Print your name and address on the reverse of this form so that we can return this extra fee): <br /> n card toyou. v <br /> m ■Attach this form to the front of the mailpiece,or on the back if space does not 1.,E] Addressee's Address <br /> ■Wri el t'Return Receipt Requested'on the mailpiece below the article number. 2•El Restricted Delivery N <br /> d ■The Return Receipt will show to whom the article was delivered and the date <br /> delivered. Consult postmaster for fee. a <br /> 0 3.Article Addressed to: 4a.Article Number V <br /> �Iart�S�P 9-f}.N. SWea-t 3 - v- �� Ir <br /> a 4b.Service Type <br /> rn <br /> o 'O' x 41� ❑ Register Al", ertified p� <br /> 4 <br /> n '9536.-1 ❑ Expre M ❑ Insured <br /> ❑ Retum pt r 14arct�a i COD <br /> 7. Date of D liv' ` p o <br /> 5.Received By: (Print Name) 8.Addressa 's A s( if requested Y <br /> and fee is p C <br /> L I <br /> 6.Sign e: (Addressee or ent ~ <br /> o X <br /> H <br /> PS F06 11,December 1994 102595-99-13.0229 Domestic Return Receipt <br /> - ter?• .fY <br /> i <br /> CIA <br /> i <br /> .. _ . - <br /> 111.. <br />
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