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COMPLIANCE INFO_1997-2002
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HARLAN
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16500
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2300 - Underground Storage Tank Program
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PR0231554
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COMPLIANCE INFO_1997-2002
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Last modified
4/28/2021 4:00:13 PM
Creation date
6/3/2020 9:50:24 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1997-2002
RECORD_ID
PR0231554
PE
2361
FACILITY_ID
FA0005678
FACILITY_NAME
LATHROP SHELL
STREET_NUMBER
16500
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
16500 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231554_16500 S HARLAN_1997-2002.tif
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EHD - Public
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la <br />■Complete ite s an or for a ditiona services. <br />■Complete items 3, 4a, and 4b. <br />• Print your name and address on the reverse of this form so that we can return this <br />card to you. <br />■Attach this form to the front of the mailpiece, or on the back if space does not <br />permit. <br />■Write'Return Receipt Requested' on the mailpiece below the article number. <br />■The Return Receipt will show to whom the article was delivered and the date <br />delivered. <br />3. Article Addressed to: <br />AWN JOHN GOETZ <br />CIRCLE K STORES INC. <br />GASOLINE ENVIRONMENTAL <br />601 UNION STREET, SUITE <br />SEATTLE WA 98101 <br />1R 5. eiVe: (Print ame) � <br />� Qom/ � <br />6. SXnatur (A resse 011 <br />`�`- <br />a� <br />PS Form 3811, December 1994 <br />I also wish to receive the <br />following services (for an <br />extra fee): <br />1. ❑ Addressee's Address <br />2. ❑ Restricted Delivery <br />Consult postmaster for fee. <br />va Aruae Uquilliuvi.Z 60 E <br />ice Type <br />, ,C <br />Itered Ire'eertified <br />iss Mail ❑ Insured c <br />COMPLIANCE Receipt for Merchandise ❑ COD <br />L <br />Q <br />3920 #Delivery APR 0 4 1997, o <br />`` T <br />8. Addressee's Address (Only if requested <br />and fee is paid) t <br />Return <br />
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