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i <br /> OD <br /> - <br /> San Joaquin County .ENSip 0 4 2008 <br /> V)R <br /> Environmental Health Department p ' GNMM NTHL AL1N <br /> 600 E. Main Street EF?rvPr/SERVIf E3 <br />` Stockton, CA 95202 <br /> RE: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR.- <br /> SITE NAME: <br /> ADDRESS: 3 S �J?' r2 t_�cL QAC- e <br /> Complete #1 if there are multiple site landowners. <br /> Complete #2 if you are the sole site landowner. <br /> 1. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code- <br /> Name of Primary or Active Responsible Party: <br /> I' 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 /> s <br /> 2. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health & Safety Code: <br /> Name of Responsible Party: <br /> I, M MA M Q U-C) M t�I� t�cls certify I am the sole title owner for the <br /> above site. <br /> Sin <br /> Signature ` <br /> i <br />