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r <br /> j, <br /> son Joaquin County <br /> Environrnerttal HrDM Department <br /> 304 E.weber Avenue. Third Fkaor <br /> Stockton, CA 95202 <br /> RE; CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR-. <br /> SrM NAME: P �fr� <br /> ADDRESS. W r q <br /> Complete#1 if there are rwitip a site andownerg. <br /> Complete a it you are the ado alto lando uncr. <br /> 1. in awomance with Sedan 25297.15(a)of Chapter 6.7 of the'NeaM&Safery Code: <br /> Name of PftmaryorAdNe Rrapon$Mle Partr <br /> tr barM ftt the follomAng is a i <br /> compute IM or current mKad um sae ownem ane their u amng addnes"s for the <br /> 3b"hits; <br /> i; <br /> , I <br /> 2 In e000*nce wilh�S�2=97.1*a)of ChapW V of the Health&Safely Cade: <br /> No C.H.P. For removal of gas tanks and <br /> teU4,Vol <br /> s. <br /> I,. 4_ 711 omrtify I am the sole tine owner for axe <br /> S1noa IY5 i. <br /> Sip o= <br /> li- <br /> i, <br /> i <br /> I <br /> ; x TOTAL- P-02 <br /> Z •d OZSO-See reoa) UbaanUW 18391W / UIIIAHS d9e s 10 SO 62 das <br />