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3500 - Local Oversight Program
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PR0545342
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
2/12/2020 10:47:18 AM
Creation date
2/12/2020 8:53:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545342
PE
3528
FACILITY_ID
FA0000392
FACILITY_NAME
FLAMES LIQUOR
STREET_NUMBER
1301
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95242
APN
03104030
CURRENT_STATUS
02
SITE_LOCATION
1301 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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a� <br /> DDDDNED <br /> OCT 12 Zola } <br /> ENVIRONH <br /> T <br /> PERM 1SERVICES <br /> San Joaquin County <br /> Environmental Health Department <br /> 600 E. Main Street <br /> Stockton, CA 95202 <br /> Subject: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR: <br /> SITE NAME: <br /> ADDRESS: /3 14p ,- Z <br /> Complete #1 if there are multiple site landowners. <br /> Complete#2 if you are the sole site landowner. <br /> 1. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code: <br /> Name of Primary or Active Responsible Pa <br /> certify that the following is a <br /> complete list of current record fee title owners and their mailing addresses for the <br /> above site: <br /> Gr-4 ' n z 7r o�� c mm�a� po/ ZX. <br /> 6f-417f/ �� y <br /> 5�l <br /> s 5- �Z!7''r6 � ,L hC: � 3Z�/ �• /�L'�lrrr�,�r. �f-✓11x 4 U!/,) r Gr' �' �'oZZ/.L <br /> 119�lh ; ern7 <br /> 2. In accordance with Section 25297.15(a)of Charter 6.7 of the Health &Safety Code: <br /> Name of Responsible Party: <br /> I, certify I am the sole landowner for the <br /> above site. <br /> Sincerely, <br /> Signature Date <br /> Revised 12/15/09 <br />
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