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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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p 1994 <br /> Rec w <br /> - Certified Maif <br /> No Insurance Coverage Provided <br /> Do not use for International Mail + <br /> POSiu SEWfcf <br /> (see Reverse) _ <br /> sent tOJ11'1 ESCOBAR <br /> treat and No. <br /> P.O.,State and ZIP Code <br /> STOCKTON CA 95202 <br /> Postage' $ .29 <br /> }Certified Fee <br /> I Special Delivery Fee <br /> l <br /> Restricted Deiivery Fee <br /> Return Receipt showing 1.00 O 0 <br /> p� to Whom&Date Delivered <br /> Return Receipt Showing to Whom, <br /> C Date,and Addressee's Address <br /> 7 <br /> 'n TpT Postage $ 2.29 <br /> 0 &Fees es <br /> C Postmark or Date <br /> M , <br /> P <br /> 0 <br /> 55) ! also tsh receive the <br /> rn Complete items t andlor 2f( Itional services. xtra N <br /> y Complete iti 3„ancir4a& .. follOwing�Bf o �A P v . <br /> so that we can <br /> • your name and address on the reverse of this fo <br /> U) Print <br /> fee): .: <br /> 8 return this card to you. m i <br /> > • Attach this form to the front of the mailpill or on the back if space 1. ❑ Addressee's Address N i <br /> does not permit. f2 t <br /> le number <br /> m • Write"Return Receipt Requested”on the mailpiece below the rd le 2 ❑ Restricted Delivery y <br /> 's • The Return Receipt will show to whom the article was delivered and the date ' <br /> o delivered. Consult postmaster for fee. a �. <br /> 0 3. Article Addressed to: 4a. Article Number C . <br /> K« P 298 999 816 r r <br /> m JIM ESCOBAR <br /> CL 4b. Service Type <br /> E CITY OF STOCKTON ❑ Registered ❑ Insured <br /> 425 N EL DORADO ST RM 312 ertified ❑ COD l: <br /> sin STOCKTON CA 95202 D Express Mail ❑ Return Receipt for 3 <br /> us p Merchandise <br /> � o <br /> C 7, Da of Delivil '~ , <br /> 7-� 3 <br /> Q o . <br /> T <br /> 5. Signature {Addresseel 8. Addressee's dress(Only if requested x <br /> and fee is ai <br /> as <br /> 1 <br /> Signature (Agent► ~ <br /> 3 <br /> T PS Form 3811, December 1991 *u.s.GPo:1992z---3n23-402ESTIC RETURN RECEIPT <br />
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