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3500 - Local Oversight Program
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PR0545641
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ARCHIVED REPORTS
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Last modified
5/5/2020 3:06:11 PM
Creation date
5/5/2020 2:11:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
RECORD_ID
PR0545641
PE
3528
FACILITY_ID
FA0002480
FACILITY_NAME
SHOP N GO 3
STREET_NUMBER
4511
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11023011
CURRENT_STATUS
02
SITE_LOCATION
4511 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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F 1 <br /> San Joaquin County Public Health Services <br /> Environmental Health Division <br /> 304 E. Weber Avenue, Third Floor <br /> Stockton, CA 95202 <br /> RE: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR: <br /> SITE NAME: A-rc.p n rtr <br /> ADDRESS: <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 Party: <br /> 1, 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 /> S <br /> 1 _ <br />'. 2. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code: <br /> Name of Responsible Party:411a 'L <br /> 7 <br /> certify I am the sole landowner for the <br /> above site. <br /> Sincerely, <br /> a Vkl / 5 <br /> Signature <br />
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