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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545289
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
2/11/2020 11:39:49 AM
Creation date
2/11/2020 8:33:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545289
PE
3528
FACILITY_ID
FA0003828
FACILITY_NAME
VAN BUSKIRK GOLF COURSE
STREET_NUMBER
1740
STREET_NAME
HOUSTON
STREET_TYPE
AVE
City
STOCKTON
Zip
95206
APN
16307036
CURRENT_STATUS
02
SITE_LOCATION
1740 HOUSTON AVE
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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-Z 4 463 <br /> Re 1eC pt for Certified fail <br /> PUBLIC W <br /> 010CS DI-RECTOR <br /> CTS OF STOCKxON <br /> t}25 N EL DORADO CA g5202 <br /> STOCKTON <br /> Pose <br /> C,roed Fee <br /> Waal Delivery Fee <br /> Pi�trided Deliver!Fee <br /> Receipt St+ovvingto <br /> rn R Date De4vered <br /> SeWr �p�ygSoy9igm <br /> � oate,h+, egsAoass $ <br /> �p TOTAt postage&Fees <br /> Posl,,tw or Date <br /> 0 <br /> w <br /> ry <br /> � a, Date of Dei <br /> n b Please Print Clearly) f n <br /> A. Received y( �C <br /> fete <br /> 2 and 3.Aiso comp i]Agent <br /> ■ Complete items 1 is <br /> sired. nature <br /> item 4 it Restricted Delive ss on the reverse C. Sig ❑Addressee <br /> ■ Print your name and ache card to You•VI l .tele, X r rn item 1? ❑Yes <br /> so that we can return the Y ditierent fro [3 NO <br /> this card to the back oft D. Is delive address low; <br /> ■ Attach rmits enter delivery address be <br /> or on <br /> if P It YES, <br /> 1, Article Addressed to: <br /> `3�*�S GIOT O OR ice Type <br /> DISC' <br /> Pfl$�,IC WORD 3 Certified Mail ❑ExPfess Mail t for Merchandise <br /> STO�TON Registered ❑Return Receip <br /> cT� OF ❑ ❑C.o-D. <br /> N EL D01WO ❑Insured Ma'l Fee) <br /> 25 ❑Yes <br /> CA 95202 4. Restricted Deli <br /> S�O�xONvery?(Extra <br /> t m sentic�bel) i02595.00•µ-0952 <br /> 2, Article Numher(CoA <br /> omestic Bet'n R�t <br /> July 1999 VLe <br /> PS form 38T11' <br />
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