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SITE INFORMATION AND CORRESPONDENCE_CASE 2
Environmental Health - Public
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SITE INFORMATION AND CORRESPONDENCE_CASE 2
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Last modified
3/13/2020 10:20:03 AM
Creation date
3/10/2020 12:05:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
CASE 2
RECORD_ID
PR0545492
PE
3528
FACILITY_ID
FA0000309
FACILITY_NAME
MCHENRY STATION & MINI MART
STREET_NUMBER
1405
STREET_NAME
MAIN
STREET_TYPE
ST
City
ESCALON
Zip
95320
CURRENT_STATUS
02
SITE_LOCATION
1405 MAIN ST
P_LOCATION
06
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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� $ <br /> C.. Nmpilleete <br /> t7_o ■ 2 for additional servic4.w <br /> I also wish to receive thentyour items 3,4a,and 4b. following, fy�r <br /> Print your name and address on t e reverse oc n return this extra fee) jj,, <br /> :card to you. F <br /> Attach this form to the front of the ail 10 <br /> of 1. ❑ Addressee's Address <br /> % <br /> 4) permit. <br /> ■Write'Return Receipt Requested' n t mallpcle number. 2. ❑ Restricted Delivery � z <br /> c ■The Return Receipt will show to whom the article was delivered and the date <br /> delivered. Consult postmaster for fee. ` <br /> 9- umber <br /> 4a.3.Article Addressed to: Artic a N <br /> -- <br /> E J D HIGHTO`dER 4b.Service Type «' <br /> ❑ Registered Certified CITY OF ESCAL4(Al <br /> Cn <br /> LU <br /> P O BOR 248 ❑ Express Mail ❑ Insured <br /> r <br /> ESCALON CA 95320 ❑ Retum Receipt for Merchandise ❑ COD <br /> o . <br /> 7.Date of Delivery <br /> �Z o <br /> 5 5.Received By: (Print Name) 8.Addressee's dress(Only if requested <br /> 4 w and fee is pa ) _ z ! <br /> g 6.Signature: (Addressee or Agent) <br /> o X <br /> Domestic Return Receipt <br /> PS Form 3811, December 1994 , <br /> F <br /> Z. 224. 3 6.4 : 4,52 <br /> US Postal-Servioe- <br /> _Receipt for Certified Mail <br /> + f J D HIG1ftdWER , ; 5 <br /> CITY OF ESCALON <br /> P O BOR 248 <br /> ESCALOIQ +T d <br /> Postage $ c <br /> Certified Fee <br /> Special Deliveryfee <br /> Restricted Delivery Fee <br /> LO — <br /> ;,� Return Receipt Showing to- <br /> Who &Date Delivered _ <br /> n Retum Receipt Showing to Wham, <br /> Q Date,&Addressee's Address <br /> 0 TOTAL Postage&Fees <br /> c') Postmark or Date ' <br /> 3 <br /> LL <br /> ... .-.. (L <br /> i <br />
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