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San Joaquin County <br /> Environmental Health Department " <br /> 600 E. Main Street <br /> Stockton, CA 95202 <br /> Subject CERTIFICATION OF RECORD FEE TITLE OWNERS FOR PENDING"NO <br /> FURTHER ACTION REQUIRED" (CASE CLOSURE) NOTIFICATION: <br /> SITE NAME: - at"-; k 7 6 <br /> ADDRESS: 1630 Sa. QL✓Ae Avk'. S-�ecic)Coa) <br /> Complete#1 if there are multiple site record title fee owners. <br /> Complete#2 if you are the sole site record title fee owner. <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, M14C ARU�C�O'�.->raR Q_Swt,I-Je. certify under penalty of perjury that to the <br /> best of my (our) knowledge, the following is a complete list of current record fee title owners <br /> and their mailing addresses for the above site, and that I have notified each record fee title <br /> owner that the Local Oversight Program Case No. " 7- on the site is being considered for a <br /> "no further action required" case status (case closure) by the San Joaquin County <br /> Environmental Health Department: <br /> Lt.�grfc 17A 'iAst Sc-A gmAe^J <br /> / f <br /> ,,2 6 7 7 Z 0 Los •'LL s /21Z f'✓A= -- <br /> �..os <br /> 2. In In accordance with Section 25297.15 (a)of Chapter 6.7 of the Health & Safety Code: <br /> Name of Responsible.Party: <br /> I, certify under penalty of perjury that to the best of <br /> my knowledge I am the sole record title fee owner for the above site. <br /> 7 se- a <br /> Signature Date <br /> I <br />