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. (f� Frtej Fr� <br /> t ,Jrt� <br /> San Joaquin County Public Health Services <br /> Environmental Health Division <br /> 304 E. Weber Avenue, Third Floor <br /> Stockton, CA 95202 <br /> RE: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR: <br /> SITE NAME: A'r, �E7x_U <br /> ADDRESS: V70 VV/r Q- d Zj�n ', G►/�, gSa0 <br /> -..Complete #1 if.th re-are-Mu ltipie site-landowners <br /> Complete #2 if you are the sole site landowner. <br /> 1. 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 . r 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 /> wH rz t� �vi€�ic-c�o��v X70 9 Dlqvrs 9D szvG,;/-'7V� <br /> AJ l <br /> ell Ll C? <br /> In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code: <br /> --t—_t _ ,Q, , .- •Name-of�RespDnsible_Party __ -_ �. .�. - ,� � ....•, <br /> 1, certify I am the sole landowner for the <br /> above site. <br /> Sincerely, <br /> Signature <br />