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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0517411
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
7/27/2020 2:07:35 PM
Creation date
7/27/2020 10:54:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0517411
PE
2950
FACILITY_ID
FA0013411
FACILITY_NAME
PAYLESS SHOE STORE
STREET_NUMBER
1160
Direction
W
STREET_NAME
YOSEMITE
City
MANTECA
Zip
95337
APN
21902033
CURRENT_STATUS
01
SITE_LOCATION
1160 W YOSEMITE
P_LOCATION
04
QC Status
Approved
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LSauers
Tags
EHD - Public
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POStal Service <br /> CERTIFIED <br /> C3 (Domestic <br /> Provided) <br /> m i F C . <br /> M <br /> —0 Postage $ a <br /> P <br /> Certified Fee 4 ' <br /> O Return Receipt Fee ' Postmark <br /> 0 (Endorsement Required) Here <br /> I3 Restricted Delivery Fee .� <br /> (Endorsement Required) 1r <br /> CIO <br /> �+ Total Postage& <br /> N EXECUTIVE OFFICER n <br /> sent To z C10 JAMES L L BARTON <br /> C3 # CVRWOCB <br /> C# Feet'aat.No.; w UNDERGROUND STORAGE TANK UNIT <br /> or PO Box No. <br /> City Sure;zlp+a °11020 SUN CENTER DR #200. . <br /> RANCHO CORDOVA CA 95670-6114 <br /> • , <br /> IIIIIIIIIIIIM ��OMPLETE THIS SECTION ON, <br /> ELtVERy <br /> ■ Complete items 1, .Also Complete i aturci <br /> item.4 If Restridted Delivery' is desired. <br /> ■ Print your narhe�and address on the reverse int <br /> so that,,We-sari return the card to you. ressee <br /> ■ Attachthis card to the back of the mailpiece, B. tinted Name) C• Da#e of Delivery <br /> or on the front if space pe <br /> I. Article Addressed to: D. Is deiivea D Yes <br /> If YE6r,' jd <br /> me <br /> rr�� <br /> EXECUTIVE OFFICER 2(101V Y 6 20 <br /> - CIO JAMES L L BARTON Z f <br /> cvRwQca � ` �T�,prOiUMEfV FAL HEALTH <br /> UNDERGROUND STORAGE TANK UNIT 3. 5ervlc`ex �- <br /> 11020 SUN CENTER DR #200 0 Cartifred,lylat p � CES <br /> RANCHO CORD/OVA CA 95670.6114 1 Re9lstered ❑Retum Receipt for Merchandise <br /> Yc'�QMi� �/� # ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ._ ❑Yes <br /> 2. Article Numller -- - <br /> (f3ansfer from service label) t. 7 010 2780 0 0 0 0 .6 6 3 7 3130 :" .T <br /> PS Form 3811,February 2004 Domestic Return Receipt <br /> 102595-02-M-1540 <br />
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