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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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13889
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3500 - Local Oversight Program
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PR0545719
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
11/19/2024 3:47:36 PM
Creation date
6/3/2020 11:22:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545719
PE
3528
FACILITY_ID
FA0005335
FACILITY_NAME
CHARLES JACOBS
STREET_NUMBER
13889
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
13889 W HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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LSauers
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EHD - Public
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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION . <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> ,_D item 4 if Restricted Delivery is desired. Q..4gen4 <br /> m ■ Print your name and address on the reverse sora <br /> M ' so that we can return the card to you. =jr <br /> d Name) C. Otte 'tDelivery <br /> ■ Attach this card to the back of the mailpiece, w i <br /> s or on the 11fppro��nt if space permits. m tq 0 N. <br /> Im 1. ArticAPR -01010 d w: ❑No <br /> APR1 5 2010 <br /> 0 <br /> E= ' Charles &April Jacobs ENVIRUiviot!V( I t <br /> 13889 W. Hwy 12 <br /> 3. J <br /> Lodi, CA 95242 5 �� <br /> Certified Mall ❑Express Mall <br /> FU NFA Letter-MI 0 Registered 0 Return Receipt for Merchandise <br /> s 0 Insured Mail 0 C.O.D. <br /> e^ <br /> O 5� 4. Restricted Delivery'?(Exam Fes/ 0 Yes <br /> M1 �, 2. Article Number 7009 2250 0001 8334 1386 <br /> (iransier from service labeQ <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540: <br />
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