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SAN. JOAOUIN --- COUNTY-- -- Environmental Health Department BUSINESS INFORMATION DESIGNATED RESPONSIBLE PARTY LAST NAME LEGAL BUSINESS NAME: Johnson Greene Brothers Farm, Inc. RESPONSIBLE PARTY MAILING ADDRESS: 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: BUSINESS LOCATION EMAIL ADDRESS: ASSESSOR'S PARCEL NUMBER: PLANNING APPLICATION NUMBER. CONTACT LAST NAME I CONTACT FIRST NAME: CONTACT BUSINESS TITLE. 051-320-12 PA -2000007 LAST NAME SOLE PROPRIETORSHIP ONLY): CONTACT MAILING ADDRESS: I CITY: FIRST NAME SOLE PROPRIETORSHIP ONLY): I STATE I ZIP CODE: 75 N. Main St. #223 Willits BUSINESS TITLE SOLE PROPRIETORSHIP ONLY): CONTACT RELATIONSHIP TO BUSINESS: PHONE NUMBER: I EMAIL ADDRESS: Owner/CEO 707-671-3754 Idoubleagreene@gmail.com BUSINESS MAILING ADDRESS. CONTACT LAST NAME: CITY: I STATE I ZIP CODE: lZachary Principal Attorney & CEO, Drivon Ccd CONTACT MAILING ADDRESS: CITY: PHONE NUMBER: EMAIL ADDRESS. CA 195219 CONTACT RELATIONSHIP TO BUSINESS PHONE NUMBER: I EMAIL ADDRESS: General Counsel 209 636-4856 izach@drivonconsulting.com BUSINESS ENTITY STRUCTURE: X Corporation ❑ Limited Liability Company ❑ Limited Liability Partnership ❑ Limited Partnership ❑ General Partnership ❑ Sole Proprietorship ❑ Joint Venture ❑ Trust ❑ Sovereign Entity ❑ Other (specify): Is this applicant business entity a foreign corporation? No ElYes — Attach Foreign Corporation's Certificate of qualification issued by the California Secretary 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 El 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: I RESPONSIBLE PARTY BUSINESS TITLE. Johnson IMichelle jCF0 RESPONSIBLE PARTY MAILING ADDRESS: CITY: I STATE: I ZIP CODE: 11045 Hills Ranch Rd Mendocino CA 195460 RESPONSIBLE PARTY RELATIONSHIP TO BUSINESS: PHONE NUMBER: I EMAIL ADDRESS. Owner/ CFO 925-989-9636 Imijohnson2OO@aol.com CONTACT #1 CONTACT LAST NAME I CONTACT FIRST NAME: CONTACT BUSINESS TITLE. Greene jAaron ICEO CONTACT MAILING ADDRESS: I 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 Idoubleagreene@gmail.com CONTACT #2 CONTACT LAST NAME: CONTACT FIRST NAME: I CONTACT BUSINESS TITLE: Drivon lZachary Principal Attorney & CEO, Drivon Ccd CONTACT MAILING ADDRESS: CITY: I STATE: ZIPCODE: 3439 Brookside Road, Suite 104 Stockton CA 195219 CONTACT RELATIONSHIP TO BUSINESS PHONE NUMBER: I EMAIL ADDRESS: General Counsel 209 636-4856 izach@drivonconsulting.com 12/11/19 2 of 2