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RECEIVED <br /> NOV 06 <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/gFRVIf;FS <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: <br /> ADDRESS: o"?�I3/ F. IYlgt,��cl {�oe��, -Fe�k-fe�w1 , ct� 9-SOS_ <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, 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 /> I, `�Y1cos��"y � certify I am the sole landowner for the <br /> above site. <br /> Sincerely, <br /> A, _/_,t-�Y A�-� <br /> Signature Date <br /> Revised 12/15/09 <br />