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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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120 (STATE ROUTE 120)
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17717
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3500 - Local Oversight Program
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PR0545633
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
11/19/2024 4:01:10 PM
Creation date
5/4/2020 12:44:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545633
PE
3528
FACILITY_ID
FA0000695
FACILITY_NAME
MOOD-N-FOOD MART
STREET_NUMBER
17717
Direction
E
STREET_NAME
STATE ROUTE 120
City
RIPON
Zip
95366
APN
20322020
CURRENT_STATUS
02
SITE_LOCATION
17717 E HWY 120
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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LSauers
Tags
EHD - Public
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J Y <br /> r• <br /> I a o wish to receive the follow- <br /> - ❑Complete items 1 and/or d se ces. ing services(for an extra fee): <br /> Complete items 3,4a,an 4b. <br /> p Print your name and add ss 1 v of ihi 1 0 c urn this n <br /> card to you. 1. ❑ Addressee's Address <br /> d Attach this form to the front of t madpi ,or on the ba spice does not <br /> perm. 2. ❑� 314 WR99g W <br /> ❑Wnle'Reium Receipt Requasted'on the mailpiece below th um <br /> The Aetum Receipt will show to whom the arkle was deliv a 1e �- <br /> c o delivered. <br /> rijCD <br /> f13.Article Addressed to: 4a.�lrt le N ber <br /> 1ALI SAHEH ALI ZANABA 4b.Service Type m <br /> MARY LZWUORS El Registered rtified s <br /> 1117 17 E HWY 120 ❑ Express Mai! insured E <br /> c <br /> � N <br /> rU PON CA 95336 ElReturnReceipt for Merchandise [ICOD 3 <br /> o <br /> cn 7.Date of Delivery 3 t � <br /> N C30 ��� °s. <br /> o <br /> CL 5 Re eiv d By: (Print N me) 8.Addressee's Add re n!y if requested and c <br /> U) 1V fee is paid} CO <br /> 3 ig re(Addresse or Agent) <br /> a°. <br /> N <br /> P Form 3811,December 1994 102595-99-a-0223 Domestic Return Receipt <br />
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