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COMPLIANCE INFO_2025
Environmental Health - Public
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EHD Program Facility Records by Street Name
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E
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ELEVENTH
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1935
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1900 - Hazardous Materials Program
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PR0521224
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COMPLIANCE INFO_2025
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Entry Properties
Last modified
10/24/2025 3:54:35 PM
Creation date
2/26/2025 2:46:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
2025
RECORD_ID
PR0521224
PE
1919 - HMBP-CO2 Only Food Facility
FACILITY_ID
FA0013846
FACILITY_NAME
JACK IN THE BOX #4300
STREET_NUMBER
1935
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23217017
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\bmascaro
Supplemental fields
Site Address
1935 W ELEVENTH ST TRACY 95376
Tags
EHD - Public
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A s <br />PS Form 3800, January 2023 See Reverse for Instructions <br />nj <br />=o <br />cr <br />co <br />LO <br />O' <br />□ <br />r-q r- □ <br />Hi <br />2T <br />□ <br />ru <br />m <br />O' □ <br />Total P< <br />I <br />o <br />HJ <br />LT) <br />F I C <br />Services & Fees (checkbox, add. <br />$_ $_ $_ <br />O I <br />Certified Mall Fee <br />»____ <br />Extra,------------- ____________ <br />U Return Receipt (hardcopy) <br />□ Return Receipt (electronic) <br />□ Certified Mall Restricted Delivery <br />□ Adult Signature Required <br />□ Adult Signature Restricted Delivery $ <br />Postage ------------ <br />U.S. Postal Service" <br />CERTIFIED MAIL" RECEIPT <br />Domestic Mail Only <br />LARSON, CAROLYN J TR <br />s^Hb 3 MADRONO AVE <br />sf^eia CORTE MADERA CA 94925-1646 <br />RE: PR0521224’HMBP RTN: MD
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