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CO0054017 (2)
Environmental Health - Public
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4200 – Liquid Waste Program
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CO0054017 (2)
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Last modified
8/25/2021 3:46:52 PM
Creation date
8/25/2021 3:38:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
CO0054017
PE
4200
STREET_NUMBER
769
Direction
E
STREET_NAME
WILLOW
STREET_TYPE
RD
City
MANTECA
Zip
95337
APN
24105117
ENTERED_DATE
7/8/2021 12:00:00 AM
SITE_LOCATION
769 E WILLOW RD
RECEIVED_DATE
7/8/2021 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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II II II 111 11111 11111 11111 <br />9590 9402 5616 9274 2246 08 <br />DERROL D & EDITH G ELLIOT <br />769 E VVILLOW AVE <br />MANTECA CA 95337 <br />C00054017 07/19/2021 Ad <br />COMPLETE THIS SECTION ON DELIVERY SENDER: COMPLETE THIS SECTION <br />Complete items 1, 2, and 3. <br />Print your name and address on the reverse <br />so that we can return the card to you. <br />MI Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />Article Addressed to: <br />Article Number (Transfer from service label) <br />A. Signature <br />'" 'UNIT ii <br />'NVIVNTAI, II EA1.311 <br />'Service Type <br />0 Adult Signature <br />O 6dult Signature Restricted Delivery <br />.Certified Mail® <br />0 Certified Mail Restricted Delivery <br />0 Collect on Delivery <br />7019 1640 0001 5361 8189 <br />El Agent <br />El Addressee <br />C. Date of Delive <br />7/2 <br />LI Yes <br />0 No <br />ived by (Printed Name) <br />0. Is,fieli\i,Styltc*erels different from item 1? <br />If YES;-entbr del very address below: <br />0 Priority Mail Express® <br />0 Registered MaiITM <br />0 Registered Mall Restricted <br />Delivery <br />o Return Receipt for <br />Merchandise <br />0 Collect on Delivery Restricted Delivery ignature ConfirmationTTM <br />Mail 0 Signature Confirmation <br />Mail Restricted Delivery Restricted Delivery <br />)0) <br />PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
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