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h <br /> } San Joaquin County <br /> Environmental Health Department <br /> s 600 E. Main Street <br /> Stockton, CA 95202 <br /> Subject: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR: <br /> SITE NAME: ��.rn Service-s ! <br /> -•-•- -- <br /> ADDRESS: 932._ eigsk Fror4aa& IZoo d "SOU-R) W54h1A&M 9�1 <br /> I 1 '�.l pay►, CA. 9 5 <br /> i Complete#1 if there are multiple site landowners. <br /> Complete#2 if you are the sole site landowner. <br /> 3 I. 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, {�nU 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 /> Land , <br /> 4O 5 Ld(estinef4e,ee La��_._CA 95Z4o <br /> AI <br /> I <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, <br /> certify! am the sole landowner for the <br /> above site. <br /> Sincerely,. <br /> 1! 311 <br /> Si nature pate <br /> Rcvi sed 12/15109 <br />