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i <br /> San Joaquin County <br /> Environmental Health Department <br /> 600 E. Main Street <br /> Stockton, CA 95202 <br /> Subject: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR: <br /> SITE NAME: <br /> ADDRESS: V <br /> Complete#1 if there are multiple site landowners. <br /> Complete#2 if you are the sole site landowner. <br /> t In accordance with Section 25297.15(a)of Chapter 6,7 of the Health& Safety Code: <br /> Name of Primary or Active Responsible Party. <br /> I, s ACJ certify that the following is a <br /> complete list of current rbcord fee title owners and their mailing addresses for the <br /> above site: c <br /> 2. In accordance with Section 25297.15(a)of Chapter 6.7 of the Health &Safety Code: <br /> Name of Responsible Party: <br /> I <br /> 1, certify I am the sole landowner for the <br /> above site. <br /> Sincerely, <br /> /C7n .51 !O <br /> Si nature e <br /> Revised 12/15/09 <br />