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. .. .. . ._ _ r_, � ..� ... . ....+.� moi . u w�.ui� • , u 1 eei». IDnoJ IU : 413 f .]7b <br /> 8b95 ' ° N Ad ' ' c bIOZ ' l ' atly anvil paAiaaaa <br /> It w RECEIVED <br /> APR 01 2014 <br /> ENVIRONMENTAL HEALTH <br /> PERMITISERVICES <br /> San Joaquin County <br /> Environmental Health Department <br /> 1868 Hazelton Ave <br /> Stocldon, CA 95205-6232 <br /> Subject. CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR: <br /> SITE NAME: Fie � f3G <br /> ADDRESS : <br /> Complete #1 if there are multi le site ladowners. <br /> Complete #2 if you are the sole site Eandowner. <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 arty I .� f. � j j , �1 U 61 <br /> It � G(. Le[ L . �% r �o 1 Cz r �i u7 <br /> I certify that the following is a <br /> complete fist of current record fee title owners and their mailing addresses for the <br /> above site: <br /> 2. in accordance with Section 25297. 15 (a) of Chapter 6.7 of the Health & Safety Code: <br /> Name ofResponsible Party: <br /> `V <br /> �\1G r ti �— • G 1I� i certify f am the sole landowner for the <br /> above siter' d� sk U"Cit o ; -fI -• t i L . ,J - <br /> Sincerel{y, / f <br /> � ! f z '� ( 5L <br /> Signature Date <br /> f <br /> I ' d 96£L£LV60E Iddon .I eeWeN d90 £0 b6 i0 a <br />