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CO0054184 (2)
Environmental Health - Public
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4200 – Liquid Waste Program
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CO0054184 (2)
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Last modified
3/24/2022 12:01:28 PM
Creation date
3/24/2022 11:54:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
CO0054184
PE
4200
STREET_NUMBER
16111
Direction
S
STREET_NAME
HENRY
STREET_TYPE
AVE
City
ESCALON
Zip
95320
APN
22912030
ENTERED_DATE
8/23/2021 12:00:00 AM
SITE_LOCATION
16111 S HENRY AVE
RECEIVED_DATE
8/23/2021 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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*igent <br />Addressee <br />elivery <br />A. Signature <br />D. Is delivery address different from ite 1? <br />If YES, enter delivery address below: El No <br />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 />Attach this card to the back of the mallpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />DA SILVA JERRY EVANGELHO & <br />CHRISTINA MARIE <br />18173 STEINEGUL RD <br />ESCALON CA 95320 <br />nonoi cnnnszt R4 A G <br /> <br />11111111111 <br /> <br />11111111111 lvi 11111 <br /> <br />9590 9402 6099 0125 5585 72 <br /> <br />2. Article Number (Fransfer from service label) <br />7021 0350 0000 8150 1537 <br />0 Priority Mail Express® <br />0 Registered MaiITM <br />o Registered Mall Restricted <br />Delivery <br />0 Return Receipt for <br />Uerchandise <br />VSignature Confirmation,'" <br />0 Signature Confirmation <br />Restricted Delivery <br />3. Service Type <br />EI Adult Signature <br />Ault Signature Restricted Delivery <br />ertified Mail® <br />0 Certified Mall Restricted Delivery <br />0 Collect on Delivery <br />0 Collect on Delivery Restricted Delivery <br />Mail <br />Mall Restricted Delivery <br />JO) <br />PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
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