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RECEIVED <br /> MAY 0 2 2014 <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICFF <br /> San Joaquin County <br /> Environmental Health Department <br /> 1868 Hazelton Ave <br /> Stockton, CA 95205-6232 <br /> Subject: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR: <br /> SITE NAME: ` f lr c 2��Tu3✓q t siJcc�S ��� <br /> ADDRESS: 2�t' 3 /l�A✓u IJ� �iOCL/iOJ C/? /�3�ZDC� <br /> Complete 91 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, "12kc-5 W)LG 0 y 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 /> C iq 21ES S_2 4/Ee eg�) 6SCAcZ.J <br /> i yS3zd <br /> 7e_�6 19 /DSC—oh 2926! E ZA--L Z ESC0zV'J CA <br /> 1`.!3 ZZ) <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 _. certify I am the sole landowner for the <br /> above site. <br /> Sincerely, <br /> a41 - e� <br /> Si nature Date <br />