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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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1856
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2300 - Underground Storage Tank Program
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PR0231069
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
12/22/2021 12:06:04 PM
Creation date
3/1/2021 2:41:12 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0231069
PE
2361
FACILITY_ID
FA0001909
FACILITY_NAME
STOP N SHOP
STREET_NUMBER
1856
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
123-191-02
CURRENT_STATUS
01
SITE_LOCATION
1856 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\kblackwell
Tags
EHD - Public
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■ Complet't <br />A. Signature <br />hreverse <br />■ Print you a res of <br />X 13 Agent <br />so that w yyL� <br />CI Addressee <br />■ Attach this card to the back of the mailpiece, <br />B. Received by (Printed Name) <br />C. Date of Delivery <br />or on the front if space permits. <br />1. Article Addressed to: <br />D. Is delivery address different from item 1? ❑ Yes <br />AH M E D M UTHAN NA <br />If YES, enter delivery address below: Cl No <br />RE: STOP N SHOP <br />RECEIVED <br />1856 W COUNTRY CLUB BLVD <br />STOCKTON, CA 95204 <br />Re: PR0518332/PR0521222/PR0231069 Rtn: LB <br />(/�� <br />DEC 0.7 2021 <br />IIIIIII'II�IIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIII <br />3. Service Type ❑ Priority Mail Express® <br />❑AdultCMR�? 44jTA�i <br />❑ Adult <br />9590 9402 6099 0125 5831 47 <br />estrlcted <br />R'Certified MalnnC pp p ery <br />❑Cert fled Mail Restkatic P RTM ' ' c Receipt for <br />❑ Collect on Delivery — chandise <br />2. Article Number (transfer from C?rVIrR lahall <br />❑ Collect on Delivery Restricted Delivery 0 Signature ConflrmationTA/ <br />7021 0 3 5 0 0000 815 0 0 6 2 2v <br />Aail ❑ Signature Confirmation <br />A it Restricted Delivery Restricted Delivery <br />W� <br />PS Form 3811, July 2015 PSN 7530-02 -000-9053 <br />Domestic Return Receipt <br />hq <br />
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