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_ f <br /> APR 1 7 Pt 112.- <br /> San Joaquin County Public Health Services <br /> Environmental lHealth 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 I - (771.v)A.)S <br /> ADDRESS: I,RO-7 poor'L^- RO C`tr;C.r'�r-nom) <br /> 4 <br /> CompleteA1-if,#h.er-e;are_multiple site-l.aadpw.n�.rs <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, 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 /> i <br /> I <br /> I, <br /> x 2. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code: <br /> Name of Responsible Party: <br /> I, ! ; L✓A TIC M Ug J 12- certify I am the sole landowner for the , <br /> above site. <br /> Sin er <br /> Signature <br />