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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545438
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
3/9/2020 4:31:40 PM
Creation date
3/9/2020 1:19:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545438
PE
3528
FACILITY_ID
FA0000848
FACILITY_NAME
QUIK STOP MARKET #2121
STREET_NUMBER
1196
Direction
W
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
217-410-43
CURRENT_STATUS
02
SITE_LOCATION
1196 W LOUISE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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r - � <br /> I <br /> San.Joaquin. County. Environmental Health. Department <br /> 304 E..Weber Avenue, Third Floor <br /> Stockton,. CA 95202 . <br /> RE:. CERTIFIED LIST OF. RECORD, FEE.TITL OWNERS. FOR: <br /> SITE NAME:.- ' ti Mort k i#lz / <br /> ADDRESS // 9E L.a",sc Mw 4g-c i . CA 9 '336 <br /> Complete #1. if there are. multiple site.landowners.. <br /> Comolete##2,if.y_Qu_are_the_so_l_e site-,landowner._ <br /> 1. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code: <br /> Name of Pr'i/maty.or Active Responsible Party:. <br /> 1, Allk- W,9, t�eU, A,.. Q :k S{ep t�1kr!sil��.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 /> JL A/ArVc�3 Y�nr4sh, <br /> 7N I <br /> Q qhs CA-,yaJ G2l;��k 42,ve, <br /> JIS/3 2 <br /> 2. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health& Safety Code: <br /> Name.of.Responsible. Party: <br /> r I, certify I am the sole landowner for the <br /> above site. <br /> Sincerely, <br /> Signature <br /> !I <br /> I <br /> I <br />
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