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f <br /> y� <br /> 3 <br /> 7 <br /> 9 <br /> i <br /> f <br /> San Joaquin County <br /> £ Environmental Health Department <br /> 600 E. Main Street <br /> s Stockton, CA 95202 <br /> Subject: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR: i <br /> SITE NAME- <br /> y- ADDRESS: <br /> I . <br /> Complete #1 if there are multiple site landowners. <br /> Complete #2 if you are the sole site landowner. <br /> 1. In accordance with Section 25297.15(x) of Chapter 6.7 of the Health & Safety Code: <br /> Name of Primary or Active Responsible Party: <br /> ti <br /> !, certify that the following is a <br /> complete list of current record fee title owners and their mailing addresses for the <br /> above site: <br /> G <br /> II� <br /> P <br /> 2. In accordance with Section 25297.15(a)of Chapter 6.7 of the Health & Safety Code: <br /> Name of Responsible Party: <br /> 41 � �_ _ ` certify I am the sole landowner for the <br /> above site. <br /> Sincerely, <br /> Signature Date <br /> Revised 12/15/09 <br /> 1 <br />