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SITE INFORMATION AND CORRESPONDENCE_FILE 2
Environmental Health - Public
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EHD Program Facility Records by Street Name
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GRANT LINE
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455
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3500 - Local Oversight Program
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PR0545202
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SITE INFORMATION AND CORRESPONDENCE_FILE 2
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Last modified
1/27/2020 10:07:21 AM
Creation date
1/27/2020 9:23:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 2
RECORD_ID
PR0545202
PE
3528
FACILITY_ID
FA0003124
FACILITY_NAME
7-ELEVEN INC. STORE #20304
STREET_NUMBER
455
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
455 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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- I 1 <br /> led <br /> I also wish to receive the <br /> g Complete Nems 1 arrd/a r a on s following services(for an <br /> ■Complete m4a,a 4b. <br /> ■print your name <br /> and a ass a of Mn return this extra fee): <br /> l card to you. 1.❑ Add e's <br /> j <br /> Attach this foRn to the hent Ura maiipiew.a an Q hack it space not �. <br /> Apettach• 2.❑ Restricted Delivery <br /> ■C "Return Roceipr Requested"on the mallpiece bebw <br /> i ■The Return Receipt will show to whom the ankle was deliv red t Consult postmaster for fee. <br /> delivered. <br /> la.Article Numberp <br /> ---7-/g21q/,R <br /> NICK PENA ALFRED 5 BETTY PENA 46.Service Type 3 <br /> 293-7 VENEMAN RD #125 ❑ Registered *Certffied p� <br /> MODF=O CA 95350 © Express Mail ❑ Insured <br /> 0 Return Receipt for Memhandise ❑ COD $ <br /> 7.Date of Delivery <br /> 5,Heceived By:(Print Name) 8.Addressee's Addr (Only if requested <br /> and fee is paid) rC <br /> 6.Signature:(Addressee or Agent) } <br /> ! X <br /> I -q PS Form 3811,December 1994 102595-WB-0229 Domestic Return Receipt <br />
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