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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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3500 - Local Oversight Program
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PR0544809
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
9/5/2019 11:38:47 AM
Creation date
9/5/2019 11:30:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0544809
PE
3526
FACILITY_ID
FA0004030
FACILITY_NAME
THREE PALMS GROCERY
STREET_NUMBER
6732
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10110001
CURRENT_STATUS
02
SITE_LOCATION
6732 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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MONNNOW <br /> San Joaquin County <br /> Environmental Health Department <br /> 600 E. Main Street <br /> Stockton, CA 95202 <br /> Subject: CERTIFIED L.IST OF RECORD FEE TITLE OWNERS FOR: <br /> SITE NAME: <br /> } ADDRESS: J4 <br /> Complete #1 if there are multiple site landowners. <br /> Complete #2 if you are the sole site landowner. <br /> 1. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code: <br /> Name of Primary or Active Responsible Party: <br /> certify that the following is a <br /> complete list of current record fee title owners and their mailing addresses for the <br /> above site: <br /> [, L- �_1 1 /G _ - VI/Lem Y_J e` -5 I <br /> k(' ���✓lf. C tC.�1 �'►c�.'`�+7C> 5_4 L 3 C- t�ee KX lq�kl <br /> 6. i ✓1sC 4 ,'tom%q E t cy ._ �9 1 d t! . trt r i�_ c� ►'L�. t �7 G'� . 1 S /.S <br /> o z-z C_U-to q /V . 64-r , <br /> 2. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code <br /> Name of Responsible Party: <br /> 1. --- --- <br /> -_ _ certify I am the sole landowner for the <br /> above site. <br /> Sincerely, <br /> �'gnature Date <br />
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