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Opp 086- <br /> APPENDI? <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 /> Liles <br /> Corpora—tion <br /> 1856 ieldAvenue San Joaqui7 Coui�v_ StoclLton. CA <br /> Parcel No. 133-390-03 <br /> A. List any other names that have been used to identify sites: <br /> _Likes-Field: Field Avenue Annex <br /> B. Address of site if different from above: NLA _ <br /> C. Assessor's Parcel Numbers: iz �-X90-03 _ <br /> 2. Responsible Parties (Use extra pages if necessary.) <br /> Name: Name: <br /> Title: Title: <br /> Firm: Firm: <br /> Address: +443 Naw Drive Address <br /> City: _Gtockton�Cly city: <br /> Zip: Zip: <br /> Telephone: (2 948-0944 Telephone: ( ) <br /> Relationship to site: (Such as generator, hauler, etc.) Current <br /> Landowner/Operator T.Paseholders duri tiM of operation. <br /> September 1987 <br /> at9i99aa HM916019 01 Td l Ida 1 1101538 Md WO:Lo U—K40 <br />