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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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DELIVERY1SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON <br /> ■ Complete Nems 1,2,and S.Also complete A. Signature <br /> Rem 4 if Restricted Delivery Is desired. X ❑Agent <br /> ■ Print your name and address on the reverse 0 Addressee <br /> so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery I� <br /> ■ Attach this card to the back of the mailpiece, <br /> or on f 'f a rm, <br /> D. Is delivery address different qrd <br /> 11 D <br /> 1. Article dre to: It YES,enter delivery address be . Lv <br /> APR 12 20101' <br /> Charles&April Jacobs ENVIRUNIOTk <br /> PO Box 8820 <br /> Stockton, CA 95208 3' �eTy� CE <br /> Mail ❑ <br /> 13889 W. Highway 12—NFA fled Mali <br /> 9 Y 0 Registered 0 Return Receipt for Merchandise <br /> 0 Insured Mail 0 C.O.D. <br /> 4. Resldcted Delivery?(Extra Fee) 0 we <br /> 2. Article Numbrfrom servke L 71109 2250 0001 8334 1843 <br /> (transfer from _ <br /> PS Form 3811,February 2004 Domestic Return Recelpt mz6e5o2-rt-1640 1 <br /> i <br />
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