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FIELD DOCUMENTS_1997
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0506203
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FIELD DOCUMENTS_1997
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Last modified
3/31/2020 3:16:33 PM
Creation date
3/31/2020 2:12:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
1997
RECORD_ID
PR0506203
PE
2960
FACILITY_ID
FA0007271
FACILITY_NAME
LINCOLN CNTR ENV REMEDIATION TRUST
STREET_NUMBER
0
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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, d aclvvcn' <br /> p •Complete items 1 anN far additional services, I at h t0 receive the <br /> o •Complete Items 3,4a, <br /> m •Print your name and a on Ne reverse of Nis form so that we can return this fOIISerVlCes(for an I <br /> card to you. axtra e): <br /> m •Attach this form to the front of the mailpiece,or on the back if space does not ° <br /> per it. 1. ❑ Addressee's Address Z ' <br /> o •Wdte'Retum Receipt Requested'on the mailpiece below the article number. <br /> JZ -The Return Receipt will show to whom the article was delivered and the date 2. ❑ Restricted Delivery N <br /> c delivered. <br /> o Consult Postmaster for fee.. o. <br /> s. RESIDENT 4a. Ida Number <br /> E 1039 SHERIDAN WAY 7 73 Z 39cc <br /> ° STOCKTON CA 95207 ab.Service Type <br /> rn ❑ Registered C]ertified ir <br /> N <br /> w ❑ Express Mail ❑ Insured m <br /> Ir0 <br /> M-Rfum Re ipt for Merchandise ❑ COD z <br /> Z 7.Date of D livery <br /> 0 <br /> Z ° <br /> r 5.Received By: (Print Name) a.Addres a 's Address(Only ifrequesi d 'r <br /> au: _ and fee is paid) m <br /> 0 6.Signature: (Addressee or Agent) <br /> 0 <br /> Ps Form 38111 December 1994 Domestic Return Receipt <br /> d SENDER: I also wish to receive the <br /> a •Complete items 1 anNor 2 for additional services. <br /> a .Complete items 3,4a,and 4b. __ following services(for an <br /> m a Print your name and address on the reverse of this form so that we can return Nis extra fee): di <br /> card to you. o <br /> •Attach this form to the front of the malpiece,or on the back if space does not 1, ❑ Addressee's Address 2 <br /> 0 permit. o <br /> o •Wdte'Retum Receipt Requested'on the mailpiem below the article number. 2, 0 Restricted Delivery rn <br /> -The Return Receipt will show to whom the article was delivered and the dale <br /> delivered. Consult postmaster for fee. d <br /> 9° r 4a.Article Number <br /> d RESIDENT qq—+ <br /> E 1040 SHERIDAN WAY S 4b.Service Type <br /> STOCKTON CA 952 5c �o ❑ Registered Jct Certified <br /> (n rn co Z Express Mail ❑ Insured m <br /> `~ � a Return Receipt for Merchandise ❑ COD <br /> 7.Date of Delivery <br /> z T <br /> 5. eceived By: (Pnnt Name) S.Addressee's Address(Only if requested m <br /> w and fee is paid) t <br /> x rlS ^' /�Scgccr l_ <br /> 6.Signature: (Addressee or Agent) <br /> o X <br /> T <br /> PS Form 3811, December 1994 Domestic Return Receipt <br />
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