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i <br /> I <br /> i <br /> San. Joaquin County Environmental Health Department <br /> 304 E. Weber Avenue, Third Floor <br /> Stockton, CA 95202 <br /> RE: CERTIFIED LIST OF'RECORD FEE TITLE OWNERS FOR: <br /> SITE NAME: <br /> ADDRESS: <br /> Complete#1if 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 Panty: <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 /> I <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, certify I am the sole landowner for the <br /> above site. <br /> j Sincerely, <br /> l <br /> Signature d <br />