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SITE INFORMATION AND CORRESPONDENCE
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2900 - Site Mitigation Program
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PR0537118
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SITE INFORMATION AND CORRESPONDENCE
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Entry Properties
Last modified
5/27/2021 3:19:00 PM
Creation date
5/27/2021 2:48:37 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0537118
PE
2957
FACILITY_ID
FA0021303
FACILITY_NAME
WATERLOO FOOD & FUEL
STREET_NUMBER
3032
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
CURRENT_STATUS
01
SITE_LOCATION
3032 WATERLOO RD
QC Status
Approved
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SJGOV\dsedra
Tags
EHD - Public
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— 73 I Nevis Drt <br />13 <br />)7A-11.5 <br />A 1C DS <br />farpd,' 1-D1A <br />San Joaquin County <br />Environmental Health Department <br />600 E. Main Street <br />Stockton, CA 95202 <br />Subject: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR: <br /> <br />o o <br />SITE NAME: <br /> <br />ADDRESS: 3 0 3 Z t 1 ATE 1 <br />Complete #1 if there are multiple site landowners. <br />Complete #2 if you are the sole site landowner. <br />1. <br />In accordance with Section 25297.15(3) of Chapter 6.7 of the Health & Safety Code: <br />Name of Primary or Active Responsible Party: <br />LA e`. L.J c. <br />certify that the following is a <br />cornplet -: <br /> list o current record fee title owners and their mailing addresses for the <br />above site: <br />11_11E_FRI S i i <br />(0 2 <br /> <br />H-ALL /1A,C <br />5- <br />05- <br />/;,-r)efr , C A <br />c O IL4 <br />)e,sc_ iv, 0 <br />2. <br />In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code: <br />Name of Responsible Party: <br />certify I am the sole landowner for the <br />above site. <br />Sincerely, <br />ig:11214All°4 Signature <br />Date <br />Revised 12/15/09
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