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I <br /> I <br /> San Joaquin County <br /> Environmental Health Department <br /> 600 E. Main Street <br /> Stockton, CA 95202 <br /> RE: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR: <br /> SITE NAME: 5- 15 ..01�. st <br /> ADDRESS: !" 5F�1ti R�p� ; 5R'� -rte e�► <br /> Complete #1 if there are multiple site landowners. <br /> Complete #2 if youarethe sole site landowner. �� <br /> j <br /> 1. In accordance with Section 25297.15(x) of Chapter 6.7 of the Health & Safety Code: <br /> Name of Primary or Active Responsible Party: <br /> I, <br /> l+ice�- �� =' Z-- 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: v_ <br /> I` 1, certify I am the sole title owner for the <br /> above site. <br /> r <br /> Sin <br /> Signatur <br /> i • <br /> I <br /> I <br /> j <br /> i <br />