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~ San Joaquin County <br /> EnVironmenta[Vealth Department <br /> 600 E Main Street <br /> Stockton,CA '95202 <br /> Subject..CE=RTIFIED LIST OF AECORID FEE TITLE OWNERS FOR: . <br /> SITE NAME: L_ yS3S$r_ owf �'1 3 `^ <br /> ADDRESS: <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 Acture,Responsible Party: <br /> I, 5 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 /> P.O. Bax 711 <br /> OALLAS, TEXAS 75"i-Ml <br /> 5 <br /> 2. In accordance with Section 25297.15(a)of Chapter 6.7 of the Health & Safety Code: <br /> Name.of Responsible Party: <br /> !, certify I am the sole landowner for the <br /> i above site <br /> Sincerely, <br /> M <br /> Signature Date <br /> i <br /> Revised 12/15/09 <br /> R <br />