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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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JACKSON
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1702
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3500 - Local Oversight Program
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PR0545315
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
2/11/2020 12:05:30 PM
Creation date
2/11/2020 9:46:33 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545315
PE
3528
FACILITY_ID
FA0003572
FACILITY_NAME
DAVES UNION SERVICE
STREET_NUMBER
1702
STREET_NAME
JACKSON
STREET_TYPE
ST
City
ESCALON
Zip
95320
APN
227-14-011
CURRENT_STATUS
02
SITE_LOCATION
1702 JACKSON ST
P_LOCATION
06
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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P 321 093 341 <br /> ysrv�e MAR o 199 <br /> Sfi <br /> Receipt for Certified Mail 1 <br /> No insurance Covera a Provided. __ _ — - - <br /> JAMES E BRATHOVDE CEG <br /> CENTRAL VALLEY REGIONAL <br /> WATER QUALITY CONTROL BOARD <br /> 3443 ROUTIER RDTE A <br /> 95$273098 <br /> SACRAMENTO CA - <br /> POM9e <br /> Certified Fee <br /> Special Delivery Fee <br /> Restricted Delivery Fee <br /> ul <br /> rn Retum Receipt Showing to <br /> !I2 <br /> Whom&Date Delivered <br /> .= fiehxrr Receiq go"to whom, <br /> -T Dale,&Addressee's Address <br /> p <br /> O TOTAL Postage&Fees <br /> co <br /> 0 Postmark or Date <br /> 0 <br /> tL <br /> N <br /> a _ <br /> (D _ - -•tr 1I§0 wish to receive the <br /> P � 1 <br /> and/or 2 fo ad oral services. wr,,,.,;a,a.ServlP (Pr�T11e §c <br /> y WED <br /> K a & <br /> 1. 0mplete items 3,and 4a&b. so that a can <br /> 0 • Print your name and address on t reverse m <br /> yreturn this card to you. r-� atrs ace 1. ❑ Addressee's Address N <br /> • Attach this form to the front of t e +' <br /> 0 CJ CL <br /> L does not permit. 2. ❑ Restricted Delivery m <br /> m • write"Return Receipt Requested"on t e mailp e b low the article number. <br /> L <br /> +1 The Return Receipt will show to whom the article delivered and the date Consult postmaster for fee. fx <br /> `C delivered. ticle Nu b � /Y`!/ r <br /> b 3. Article Addressed to: 3 <br /> Y � M <br /> rn 4b. Service Type aY <br /> E- JAMES E BRATHOVDE CHG ❑ Registered ❑ insured c, <br /> ° VALLEY REGIONAL, ❑ COD c <br /> 5 CENTRAL Certified <br /> II WATER QUALITY CONTROL BOARD 'Express Mail ❑ Me chard serpt for o <br /> 3443 ROUTIER RD STE A Date f Deliv ry 3 <br /> a SACRAMENTO CA 95827-3098 o <br /> T <br /> Q 8. Ad nesse ddre s n1y if requested <br /> Cr 5. Signatu r sseO and fee i aid) <br /> t— <br /> 5. gn ge <br /> T 1 *U.S.GPO:t9e3-352-714 MESTIC R <br /> P5 Form 81 ecember 199ETURN RECEIPT <br /> y <br />
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