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l . <br /> RUG 28 pn .1.2 43 <br /> San Joaquin County Public Health Services <br /> Environmental Health Division <br /> 3041E. Weber Avenue, Third Floor <br /> Stockton, CA 95202 <br /> RE: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR: <br /> SITE NAME: +M AV CZ] l <br /> ADDRESS: +h <br /> _Complete..#I-if-#here-are' tip[e- te-land ers. <br /> Complete #2 if you are the sole site landowner. <br /> rl, . <br /> i� <br /> 1. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code: <br /> hle o rim r Activ esponsible Party: <br /> certify that the following is a <br /> complete ist of current record fee title owners and their mailing addresses for the <br /> above site: <br /> �r PJ , M e I E hN �� c. �'� s -P.4 �AE,�m cry 752za <br /> 1 .. <br /> 2. In accordance with Section 25297.15(x) of Chapter 6.7 of the Health & Safety Code: <br /> Name of Responsible Party <br /> hk <br /> I; certify I am the sole landowner for the <br /> above site. <br /> incer <br /> Signature <br />