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SITE INFORMATION AND CORRESPONDENCE_FILE 2
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545202
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SITE INFORMATION AND CORRESPONDENCE_FILE 2
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Last modified
1/27/2020 10:07:21 AM
Creation date
1/27/2020 9:23:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 2
RECORD_ID
PR0545202
PE
3528
FACILITY_ID
FA0003124
FACILITY_NAME
7-ELEVEN INC. STORE #20304
STREET_NUMBER
455
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
455 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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Z 128 782 817 <br /> f U,001?wtal Service ` <br /> Receipt for Certified Mail <br /> No Insurance Coverage Provided. <br /> Dn not use for Intemational Mail(See reverse) <br /> SOUTDLAND CORP <br /> 10220 S W GREENBURG RD STE 470 <br /> PORTLAND OR 97233 <br /> special Delivery Fee <br /> Restricted Delivery Fee <br /> Return Receipt Showing to <br /> Y Whom&Date Delivered <br /> Rehm Recept showing to whom, <br /> Uate,d Addressee's Addrass <br /> O MTAL Postage&Fees <br /> W <br /> co Postmark or Date <br /> 0 <br /> tL <br /> Cl) <br /> o- SENDER' I also wish to receive the <br /> cornpiete items 1 audio,2 for additional services. UNIT IV following services(for an <br /> ■Complete items 3,4a,and 4b. <br /> 0.Print your name and address on the reverse of this form so that we can return this extra foe <br /> card to ou. 1.❑ Addressee's Address <br /> ■Attach this fon,to the from c the maIlplw.,or on the back H space does not 2.❑ Restricted Delivery <br /> ppit.e n <br /> ■Write'Return R.ipt Requested'on the mallpiece below the artk re number. tar fee. <br /> ■Thra Return Receipt will show to die whom the article was delivered and date Consult poStrTtaSter <br /> delrve0 d, — 4a.Articie Number <br /> SOUTHLAKD CORP • ias • -7 S17 <br /> 102,10 S W GREENBURG FD STE 470 4b.Service Type <br /> Cert'if'ied <br /> PORTLAND OR 97233 ❑ Registered <br /> � <br /> ❑ Express Mail ❑ Insured g <br /> ❑ Return Receipt for Merchandise ❑ COD <br /> 7.Date of Delivery, <br /> S.Addressee's Addre (Onl if requested <br /> Recei By: (Prin�Na <br /> and tee is paid) <br /> 6.Siflnature:( ddregent) <br /> X <br /> .2 PS Form 8811,December 1994 w2695-es-8-(Yz i Domestic Retum Receipt <br />
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