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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545205
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
1/27/2020 3:13:33 PM
Creation date
1/27/2020 3:02:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545205
PE
3528
FACILITY_ID
FA0003164
FACILITY_NAME
NORTH POLE GAS & FOOD INC
STREET_NUMBER
574
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
574 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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17!07/2011 15: 41 2092337576 <br /> A ONE GAS FOOD PAGE d1?b1 <br /> i r' <br /> San Joaquin County <br /> Envirvrimental Health Department <br /> 600 E Main Street <br /> Stockton. CA 95202 <br /> Subject: CERTIFIED LISW OF RECORD FEE TITLE OWNERS FOR- <br /> SITE NAME: -+- <br /> ADDRESS: -i <br /> Complete#1 if there are multiple site landowners. <br /> Complete#2 If your are the sole site landowner- <br /> 1- <br /> andowner_1_ In accordance with Saction 75297.15(a)of Chapter 6-7 of the l-Iealth & Safety Code: <br /> Name of Primary or Active Resl3o/nsihle Party: <br /> 1 5,L' SV;Y C _ _certify that the following is a <br /> complete list of current record fee title owners and their mailing addresses for the <br /> above site: r� <br /> Cap <br /> 2. In accordance with Section 25297.15(a)of Chapter 6.7 of the Health &Safety Cade: <br /> Name of Responsible Party: <br /> I, 1 certify I am the sole landowner for the <br /> above site. <br /> Sincerely, <br /> ILI <br /> Signature Date <br /> Revised 12/15/09 <br />
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