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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
Scanner
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EHD - Public
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9 SENDER: I also Wish to receive the <br /> 1e followArdy.,,��r6c�s f�r �n extra 00 <br /> m Complete items t andlar 2 for �YI[[JJ�D''L 4489°°$$ }f r n <br /> • Complete items 3,and 4a&b e can feel: Z <br /> of Print your name and address on the reverse of this form so N <br /> m return this card to you. t. El Addressee's Address <br /> • Attach this form to the front of the mailDiece,or on the beck if space G <br /> does not permit. 2, ❑ Restricted Delivery <br /> 0 • Write"Return Receipt Requested-on the nca was <br /> the and he date. <br /> • <br /> Th.Return Receipt will show to whom the article was delivered and the dais Consult postmaster for fee. <br /> e delivered. qa. Article Number E <br /> 3. Article Addressed to: <br /> 9 p 298 'o' <br /> m m <br /> m CECIL DILLON 4b. Service Type ft <br /> n ❑ Registered ❑ Insured 0 <br /> E FLAG CITY ❑ COD fi <br /> ° LANE STECertified <br /> y1820 W KETTLEMAN ❑ Express Mail ❑ Return Receipt for <br /> w Merchandise <br /> LODI CA 95242 <br /> c <br /> C7. Date of De4KO q�y JC <br /> C fJ.A7 0 <br /> Q 8. Addressee's Address(Only if requested <br /> 5. Signature (Addressee) and fee is paid) r <br /> uj <br /> r <br /> 6. Signature IA9ent1 <br /> 7 <br /> > PS Form 3811, December 1991 RV.s.GPO:iBB2-323-0O2 DOMESTIC RETURN RECEIPT <br /> 0 <br />
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