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�F <br /> SEP 2 3 2005 <br /> ENVIROUIENT HEALTH <br /> San Joaquin County PE, IT/SEUICES <br /> 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: sT-Tr� C0'Ps_ ke0 -1 <br /> ADDRESS: . A +). `('+� j <br /> Complete#1 if there are multiple site landowners. <br /> -� —Complete #2.if,you are the sole-site landowner. <br /> W <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 /> i <br /> PLEASE NOTE: THE CALIFORNIA HIGHWAY PATROL, INSTALLOR OF THE <br /> WS HAS SOLE RESPONSIBILITY FOR ALL ITEMS RELATING TO THE <br /> 1 , AS THE PROPERTY OWNER, APPROVE OF THE REMOVAL OF THE L- LAS <br /> 2. In accordance with Section 25297.15(a) of Chapter 6.7 of the Health &Safety Code: <br /> Name of Responsible Party: <br /> t� r certify f am the -- <br /> a sole title owner for the <br /> above site <br /> SinccI}erelyy,,- <br /> Signature <br /> . - � ,.,' Y it J .1,F•�...X � r R -� �..'i To § r l- �.s',j.' <br /> ..vi`. :TrS`. ..i ,..� !-. t,.�.. .�_. _ �. :Ff' j. 7.r �.i.,�� <br /> J <br />