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OPP ;ra6-22 <br /> APPENDIX A <br /> REMEDIAL ACTION CERTIFICATION FORM <br /> (Please type or print in black ink, only) <br /> Instructions for completion on reverse. <br /> 1. Site Name and Location: (Street Address, County, City, and <br /> Assessor's parcel number.) <br /> Li a Corporation <br /> 1856 Field Avenue; San, Jo4auin CountyStockton CA <br /> Parcel No 133390-03 <br /> A. List any other names that have been used to identify sites: <br /> Lika ie d ! Field Avenue Annex <br /> B. Address of site if different from above: NZA <br /> C. Assessor's Parcel Numbers: 133-390-03 <br /> 2 . Responsible Parties (Use extra pages if necessary.) <br /> Name: M chael @Latt Name: <br /> Title: Title: <br /> Firm: Blatt Development_.,_- Firm: <br /> Address: 7883 N Pershing Ave Address <br /> City: Stockton CA City: <br /> Zip: 95207 Zip: <br /> Telephone: (209) 952-0225 Telephone: ( ) <br /> Relationship to site: (Such as generator, hauler, etc.) <br /> Current Landowner/Operator Currant Landowner <br /> _1- September 1987 <br /> A <br /> ZIO/�OOd 9£IM MOZ8 01 'vn qYD I N0I988 W68d 9fot m £B-8Z-to <br />