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SAN JOAQUIN COUNTY -- Environmental Health Department BUSINESS INFORMATION DESIGNATED RESPONSIBLE PARTY LAST NAME: LEGAL BUSINESS NAME: RESPONSIBLE PARTY BUSINESS TITLE: Greene Brothers Farm, Inc. IMichelle BUSINESS PHYSICAL ADDRESS: CITY: STATE: ZIP CODE: 12470 Locke Road. Ste. C Lockeford CA 95237 BUSINESS MAILING ADDRESS: CITY: STATE: ZIP CODE: 7513 Girard Ave. Ste. 1315 La Jolla CA 92037 BUSINESS LOCATION PHONE: I BUSINESS LOCATION EMAIL ADDRESS: ASSESSOR'S PARCEL NUMBER: PLANNING APPLICATION NUMBER: I EMAIL ADDRESS: 051-320-12 PA -2000007 LAST NAME SOLE PROPRIETORSHIP ONLY): CONTACT #1 FIRST NAME SOLE PROPRIETORSHIP ONLY)- NLY :BUSINESS CONTACT BUSINESS TITLE: Greene lAaron BUSINESSTITLE SOLE PROPRIETORSHIP ONLY): CONTACT MAILING ADDRESS: CITY: I STATE: BUSINESS MAILING ADDRESS: 75 N. Main St. #223 Willits CITY: I STATE: ZIP CODE: I EMAIL ADDRESS: Owner/CEO 707-671-3754 Idoubleagreeneagmail.com PHONE NUMBER: I EMAIL ADDRESS: CONTACT LAST NAME: CONTACT FIRST NAME: CONTACT BUSINESS TITLE: Drivon lZachary jPrincipal Attor ey & CEO, Drivon C BUSINESS ENTITY STRUCTURE: I CITY: Corporation ❑ Limited Liability Company I ZIP CODE: ❑ Limited Liability Partnership ❑ Limited Partnership ❑ General Partnership ❑ Sole Proprietorship ❑ Joint Venture ❑ Trust ❑ Sovereign Entity ❑ Other (specify): Is this applicant business entity a foreign corporation? X No ElYes Secretary — Attach Foreign Corporation's Certificate of qualification issued by the California of State per Corporations Code, Section 2105. Is this applicant business entity a cannabis cooperative association per Business and Professions Code, Chapter 22? X No F.] Yes —Attach List of members of the cannabis cooperative association. Name of Association: DESIGNATED RESPONSIBLE PARTY DESIGNATED RESPONSIBLE PARTY LAST NAME: I RESPONSIBLE PARTY FIRST NAME: RESPONSIBLE PARTY BUSINESS TITLE: Johnson IMichelle JCFO RESPONSIBLE PARTY MAILING ADDRESS: CITY: I STATE: ZIP CODE: 11045 Hills Ranch Rd Mendocino CA 95460 RESPONSIBLE PARTY RELATIONSHIP TO BUSINESS: PHONE NUMBER: I EMAIL ADDRESS: Owner/ CFO 925-989-9636 Iniijohnson2OO@aol.com CONTACT #1 CONTACT LAST NAME: CONTACT FIRST NAME: CONTACT BUSINESS TITLE: Greene lAaron CEO CONTACT MAILING ADDRESS: CITY: I STATE: I ZIP CODE: 75 N. Main St. #223 Willits I CA 195490 CONTACT RELATIONSHIP TO BUSINESS: PHONE NUMBER: I EMAIL ADDRESS: Owner/CEO 707-671-3754 Idoubleagreeneagmail.com CONTACT #2 CONTACT LAST NAME: CONTACT FIRST NAME: CONTACT BUSINESS TITLE: Drivon lZachary jPrincipal Attor ey & CEO, Drivon C CONTACT MAILING ADDRESS: I CITY: I STATE I ZIP CODE: 3439 Brookside Road, Suite 104 Stockton CA 195219 CONTACT RELATIONSHIP TO BUSINESS PHONE NUMBER: I EMAIL ADDRESS: General Counsel 209 636-4856 zach drivonconsultin .com 12/11/19 2 of 2