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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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6421
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2900 - Site Mitigation Program
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PR0522496
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
2/15/2019 5:26:40 PM
Creation date
2/15/2019 2:44:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0522496
PE
2957
FACILITY_ID
FA0015317
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95245
APN
05532024
CURRENT_STATUS
02
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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i <br /> v <br /> a SEN I also wish to receive the <br /> C •Complete items 1 an r 2 for ditional I s. followina rvlces fO1f nann <br /> Z •Complete items 3,4 ,an 4 � 1 I�JJ <br /> d •Pdnt your name an addre h revs a of is s h e can return this extra f E <br /> card to yyou. 1.❑ Addressee's Address 2 <br /> > •Atlach Ihls form to the fr of the mallplece, he beck if pec do 2 ❑ Restricted Delivery m <br /> `y permit. N <br /> •Write'Return Receipt Requested°on them Ilplec a Consult postmaster for fee. 6 <br /> •The Return Receipt will show to whom the nide <br /> delivered. <br /> !a.Article Number <br /> cc <br /> CECIL DILLION u� 'g3s'�1�07 <br /> 4b.Service Type <br /> En FLAGG CITY INC ❑ Registered ertified <br /> 3 1820 W KETTLEMAN LN STE 5 I Insured <br /> o LORI CA 95242 J JOExpress Mail <br /> ❑ Relurn Re ea <br /> for Merchandise ❑ COD <br /> 7 at o e 2 3 <br /> i <br /> 5.Received By: (Print Name) 8.Add s e's d ss (Only u requested <br /> and lee is pai c <br /> C� 1 bre u <br /> 6.Signature. (Addresse orA nt) <br /> 0 <br /> 2 Rs Form 3811, ecember 1994 io2595-99-B-0229 Domestic Return Receipt <br />
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