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COMPLIANCE INFO_2003-2005
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231430
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COMPLIANCE INFO_2003-2005
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Last modified
1/2/2024 12:38:04 PM
Creation date
6/23/2020 6:48:32 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2003-2005
RECORD_ID
PR0231430
PE
2361
FACILITY_ID
FA0000848
FACILITY_NAME
QUIK STOP MARKET #2121
STREET_NUMBER
1196
Direction
W
STREET_NAME
LOUISE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
217-410-43
CURRENT_STATUS
01
SITE_LOCATION
1196 W LOUISE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231430_1196 W LOUISE_2003-2005.tif
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EHD - Public
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r <br /> COMPLETE SECTIONI COMPLETE • ON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Signature ' ��r <br /> item 4 if e X ? J ❑Agent <br /> ■ Printyou n d t reverse t-�I -_< ❑Addressee <br /> so that�el� B. R ed b Printed N ) C. Date of livery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. <br /> D. Is delivery add ' Brent from Item 1? ❑Yes <br /> 1• Article Addressed to: If YES,enter delivery address below: ❑No <br /> ' I <br /> I I <br /> j QUIK STOP #121 <br /> 1196 W LOUISE AVE 3. &viceType <br /> MANTECA CA 95336 ❑certified Mail ❑Express Mail <br /> Registered ❑Return Receipt for Merchandise <br /> ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number ?004 2 510 0003 3 7 8 9 145? <br /> (Transfer from se <br /> Ps Form 3811,February 2004 Domestic Return Receipt t S-02-M7� <br />
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