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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2575
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1900 - Hazardous Materials Program
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PR0519887
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
12/22/2021 3:32:30 PM
Creation date
9/1/2021 9:29:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0519887
PE
1921
FACILITY_ID
FA0006439
FACILITY_NAME
COUNTRY CLUB MOBIL CIRCLE K
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\kblackwell
Tags
EHD - Public
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Postal <br />CERTIFIED o <br />RECEIPT M <br />r� Domestic <br />�n <br />a <br />o <br />Ln Certified Mad Fee ' <br />r -q $ N p <br />CID Extra Services & Fees (check box, add fee as apprmpnate) <br />1:3 <br />[0:1Return Recelpt (hardcopy) $ <br />1=1[1Return Receipt (electronic) $ i (Y\ \ \� <br />� El Certified Mail Restricted Delivery $ POStmark <br />❑ Adult Signature Required $ - n ,.jHere <br />❑ Adult Signature Resincted Delivery $ < AO �Q \\ A <br />O PostageLn <br />1�1�'O12 <br />M Total Postage an COUNTRY CLUB MOBIL CIRCLE K <br />$ 2575 COUNTRY CLUB BLVD <br />nj a sent To STOCKTON, CA 95204 <br />0 $treat and Apt N. <br />f�- <br />City,State;ZIP+4 Re: PR0519887 Rtn: LB <br />■ Complete itergs 1,,2, and 3. A. Signature <br />■Print your name and address on the reverse X <br />yCrq <br />so that we can return the card to you. <br />■ Attach this card to the back of the mailpiece, B. Received by (Printed Name) C. <br />or on the front if space permits. <br />1. Article Addressed to: <br />COUNTRY CLUB MOBIL CIRCLE K <br />2575 COUNTRY CLUB BLVD <br />STOCKTON, CA 95204 <br />Re: PR0519887 Rtn: LB <br />❑ Agent <br />❑ Addressee <br />D. Is delivery address different from item 1? ❑ Yds <br />If YESREC <br />delivery address below: E]No <br />EIVED <br />II UEC 0.8 2021 <br />3. ❑ d• ul�SignattSigna e Restlictb eE "ice Type ED Priority agA <br />iprted <br />III II I III III II I III III II III Certified Mail0 (� �p <br />9590 9402 6099 0125 5830 93 ❑ Certified Mad RestnctedUeflvEAyARTAA=ceipt for <br />❑ Collect on Delivery Merchandise <br />2. Article Nurl /Transfer frnm spnfirp lahph ❑ Collect on Delivery Restricted Delivery EI Signature Confirmation - <br />flail ❑ Signature Confirmation <br />7021 0350 0000 815 0 0677 flail Restricted Delivery Restricted Delivery <br />PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />
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