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CO0049646 (3)
EnvironmentalHealth
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4200 – Liquid Waste Program
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CO0049646 (3)
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Entry Properties
Last modified
11/19/2024 4:00:53 PM
Creation date
1/24/2023 1:13:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
CO0049646
PE
4200
FACILITY_NAME
WINE GROUP
STREET_NUMBER
17400
Direction
E
STREET_NAME
STATE ROUTE 120
City
RIPON
Zip
95366
APN
24505001
ENTERED_DATE
4/16/2019 12:00:00 AM
SITE_LOCATION
17400 E HWY 120
RECEIVED_DATE
4/9/2019 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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NDER: COMPLETE IHIS SECTION <br />A. Signature <br />X <br />Complete items 1, 2, and 3. 4.141.1C <br />Print your name and address on the reverse <br />so that we can return the card to you. <br />Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />El Agent <br />CI Addressee <br />e of D iArk <br />b <br />D. Is delivery address different from item 1? 1:1 Yes <br />If YES, enter delivery address below: 0 No <br />JUL 1 4 2020 WINE GROUP LLC <br />PO BOX 90 <br />!RACY, CA 95378 ENVIRONMENTAL HEALTH <br />DEPARIVIENT <br />111111 1111 1111111 II 111111111111 II <br />9590 9402 5616 9274 2249 29 <br />,11,,fer from service label) <br />d1:11 8905 <br />Priority Mail Express® <br />Registered Mail,. <br />Registered Mail Restricted <br />Delivery <br />Return Receipt for <br />Merchandise <br />Signature ConfirmationTM <br />Signature Confirmation <br />Restricted Delivery <br />3. Service Type <br />0 Adult Signature <br />dult Signature Restricted Delivery <br />ertified Mail® <br />0 Certified Mail Restricted Delivery <br />0 Collect on Delivery <br />0 Collect on Delivery Restricted Delivery ID <br />' -cured Mail 0 <br />cured Mail Restricted Delivery <br />ver $500) <br />PS Foal. July 2015 PsN 7530-02-000-9053 Domestic Return Receipt
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