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SITE INFORMATION AND CORRESPONDENCE
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3500 - Local Oversight Program
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PR0545859
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SITE INFORMATION AND CORRESPONDENCE
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Entry Properties
Last modified
6/3/2020 5:09:13 PM
Creation date
8/15/2019 11:29:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545859
PE
3528
FACILITY_ID
FA0003831
FACILITY_NAME
WATERLOO FOODMART
STREET_NUMBER
4315
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215-2305
APN
08710034
CURRENT_STATUS
02
SITE_LOCATION
4315 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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J�-11 �.ni V L.�y� <br /> CID <br /> r_ 1T Yr-.r•rr <br /> M m <br /> E3 Postage $ C3 -Postage $ <br /> C co <br /> CertH(?d Fe Certified Fee <br /> C3 Postmark p , Postmark <br /> E3 Return Receipt <br /> Fee p ReturnRec;+at Fee <br /> Here <br /> E3 (Endorsement Requind) Here p (Endorsement Required) <br /> E3 Restricted Delivery Fee p Restricted Deliverf-ee <br /> E3 (Endorsement Required) T p (Endorsement Required) <br /> Ln Total P W)FFF7 ' <br /> Fam Norby Ln <br /> ra Total F Denis Brown <br /> E3 Waterloo Food Mart and Car Wash p Shell Oil Products <br /> Sent To Sent To <br /> 0 4315 Waterloo Road 20945 S. Wilmington <br /> p at ofeo Stockton, CA 95215 C3 street,f <br /> Iti orPo,3Carson, CA 90810 <br /> i5ty shah NOR-4315 Waterloo <br /> NOR-4315 Waterloo ---"-��- <br /> >;>xar�F739s; 1!{:'. tt[1ec: �:QwV ijg?il.EF4r...nn.,n- Vt.., ,U.44. •�Ir.u: a„tet- s[]r irax <br /> , <br /> '.[91~11 �� -�.�Lliflr�a"1: <br /> a a <br /> ❑ Complete items 1,2,and 3.Also complete A. ignatur <br /> item 4 if Restricted Delivery is desired. *NA <br /> ent <br /> ❑ Print your name and address on the reverse dressee <br /> so that��yy�� ��,,,[[ wv <br /> �rn�j rd to you. Q, ceived by(Printed Name) C. a t elivery <br /> ❑ Attach tf11S' r p tkthd of the mallplede, i ( a9 <br /> or on the front if space permits. <br /> D. Is delivery address different from item ? Yes <br /> 1. Article Addressed to: <br /> If YES,enter delivery address below; ❑ No <br /> j William . Norby <br /> Watorloo Food Mart and Car Wash 3.fC <br /> ice Type <br /> 4315 Waterloo Road ertified Mail ❑Express Mail <br /> Stockton, CA 95215 egistered ❑Return Receipt for Merchandise <br /> NOR-4315 Waterloo ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> (Transfer from service 7008 0150 0000 8034 5720 <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 <br /> O e.�:;0 <br /> ❑ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. ❑Agent <br /> ❑ Print y ame n ss on the reverse ice_ ❑Addressee <br /> so th � � b, <br /> Ur and to you. Re ived by(Pri d me) C. Date of Delivery <br /> ❑ Attach this card to the back of the mallplece, <br /> or on the front if space permits. <br /> D. Is i dress differe i 1? ❑Yes <br /> 1. Article Addressed to: If YES, teiv rs below: ❑ No <br /> Denis Brown- 3 2008 <br /> Shell Oil Products <br /> 20945 S.Wilmington 3�,f0lnsured <br /> ITHsMa;l <br /> 'Carson, CA 90810Qg {�r, ERV urn Receipt for Merchandise <br /> NOR-4315 Waterloo Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number - 7008 0150 0000 8034 5928 <br /> (Transfer from set <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M•1t.0 <br />
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