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C T 1 2011, <br /> ENVI 7'D <br /> San Joaquin County <br /> Environmental Health Department <br /> 600 E. Main Street <br /> Stockton, CA 95202 <br /> (,FR'VIFIED LIST OF RECORD FFE. TITLE OWNERS FOR: <br /> SITE NAME <br /> ADDRESS: <br /> -PA <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(a) of Chapter 6.7 of the Health & Safety Code: <br /> Name of Primary or Active Responsible Party: <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 /> 2. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code: <br /> Name of Responsible Party: <br /> 11 certify i am the sole landowner for the <br /> above site. <br /> Sincerely, <br /> -7- ff <br /> Signature Date <br /> Vk-%'1'xd 17 <br />