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Environmental Health - Public
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3500 - Local Oversight Program
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PR0544481
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/20/2019 3:51:53 PM
Creation date
5/20/2019 3:09:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0544481
PE
3528
FACILITY_ID
FA0005127
FACILITY_NAME
ELLIS CAR WASH
STREET_NUMBER
820
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04742005
CURRENT_STATUS
02
SITE_LOCATION
820 S CHEROKEE LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Z-A?24 364 469 <br /> L b <br /> 4TTN PAT ANDERSON <br /> ::ENTRAL VALLEY REGIONAL <br /> RATER QUALITY CONTROL BOARD <br /> 7NDERGROUND STORAGE TANK UNIT <br /> 3443 ROUTIER RD STE A <br /> 3ACRAMENTO CAB 95$27-3098 <br /> 1998 <br /> ^Postage -- $ <br /> Certified Fee <br /> Special Delivery Fee <br /> Restricted Delivery Fee <br /> Return Receipt Showing to <br /> Whom 8 Date Delivered <br /> Return Receipt Showing to Wham, <br /> Date,b Addressee's Address <br /> 0 TOTAL Postage A Fees $ <br /> M Postmark or Date <br /> 0 <br /> LL <br /> U) <br /> ci�dompfete items 1 and/or 2 for additional services. I also Wish to receive the <br /> °Complete items 3,4a,and 4b. follo in e (jr Q <br /> n Print your name and address the re e f this for tha we can return thq extra fe `�98 <br /> card to you. <br /> Py °Attach this form to the front of i e f <br /> ;! permit. 1. ❑ Addressee's Address <br /> d o Write'Retum Receipt Requested'on the mailpie a be a article number. 2. ❑ Restricted Delivery N <br /> °The Return Receipt will show to whom the artid was delivered and the date <br /> c delivered. Consult postmaster for fee. <br /> T4a.Article Number 0 <br /> ATTN PAT ANDERSON /J <br /> c <br /> CENTRAL VALLEY REGIONAL oC • c <br /> E WATER QUALITY CONTROL BOARD 4b.Service Type <br /> UNDERGROUND STORAGE TANK UNIT ❑ Registered ertified <br /> cf at <br /> LL 3443 ROUTIER RD STE A ❑ Express Mail Insured 9 <br /> G .SACRAMZNTO CA 95827-3098 ❑ Return Receipt for Merchandise ❑ COD <br /> a 7.Date of D live .° <br /> Z <br /> qg 0 <br /> 5.Received By:(Print Name) 8.Address 's dress(Only if requested <br /> and fee Pai c <br /> c6.Signat .(Addressee or Agent) ~ <br /> N <br /> PS Form 3811, December 1994 Domestic Return RecPint <br />
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