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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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C
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CAPITOL
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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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c. also avian to receive the <br /> S I <br /> •complete items,andW 2 for net 1 owing services(for an <br /> •�01"d�nerns a'4a' form t w return 6" extra f <br /> •Prim your name end �.a <br /> card to yyou. „p _A <br /> e.s`Addr�ess <br /> •Anpeenacn lhis fomt fo t o hon <br /> •Write'Rehim RecelplRequeetad'un the mallp w <br /> •The Retum Receipt wAl stow to whom the article ea <br /> �C delivered. <br /> O <br /> WAYNE HOLLINGSWORTH <br /> 3 AMADOR CORP <br /> P O BOX 667 <br /> N BAYERSFIELD -CA 93303 <br /> 5.Received By: (Print Name) <br /> 6.Signature: (Addressee or Agent) <br /> oe X <br />
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