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RECEIVED <br /> APR 2 7 2015 <br /> ENVIRONMENTAL HEALTH <br /> PERIVIMSERVICES <br /> San Joaquin County <br /> Environmental Health Department <br /> 1868 E. Hazelton Avenue <br /> Stockton, CA 95205 <br /> Subject: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR: <br /> SITE NAME: Write <br /> AD D R E S S: / ��i /Zt E� 'I-A", 7��1J � <br /> mac°l�taPJ c� . <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 /> I, 04& 1 77Q, ! '-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 /> K,,l�/Ct� �-�, ,�.� rte,✓��c,�-��� �u� <br /> 2. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code: <br /> Name of Responsible Party: <br /> I, (?A.(-J, 4'sW 1­. ,` -u5>� certify I am the sole landowner for the <br /> above site. <br /> Sincerely, <br /> _ z <br /> Signatur Date <br /> Revised 12/15/09 <br />