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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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1130
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3500 - Local Oversight Program
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PR0545657
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/7/2020 12:24:02 PM
Creation date
5/7/2020 12:19:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545657
PE
3528
FACILITY_ID
FA0015337
FACILITY_NAME
ISLAMIC CENTER
STREET_NUMBER
1130
Direction
S
STREET_NAME
PILGRIM
STREET_TYPE
ST
City
STOCKTON
Zip
95210
CURRENT_STATUS
02
SITE_LOCATION
1130 S PILGRIM ST
P_LOCATION
01
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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SENDER: COMPLETE THIS SECTION 1 COMPLETE THIS SECTION ON DELIVERY <br /> r+ ■ Complete Items 1,2,and 3.Also complete <br /> A. SJgn ture <br /> Ln item 4 If Restricted Delivery is desired. ❑Agent <br /> r` ■ Print y, �.� on the reverse XJJd'1 ❑Addressee <br />'a so that %tiytrt=to you.y B. Received by(Printed Name) C. Date of livery II <br /> rri ■ Attach this and to the backpf the4mailplece; ) <br /> li-0 or on the 1t'rf space peFmits ll <br /> D. Is ilio es <br /> c 1. Article Addre to, — <br /> If llff ^dtlJ=. ❑No <br /> © Islamic Center of Stockton k JUL209 <br /> c, 1130 S. Pilgrim Street if <br /> co Stockton, CA 95206 3. OJITISERVICES <br /> V NFA—HK certified Mall ❑Express Mail <br /> ❑Registered ❑Return Recelpt for Merchandise <br /> © ❑Insured Mall ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 12. Article Number--^-!-'—`--` - <br /> Irg„sferftm SMVIce k6o7008 1830 0004 8693 6757 <br /> PS Form 3811,February 20134 Domestic Retum Receipt 10258502-M-1540 <br />
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