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A <br /> RECEIVE® <br /> JUL 2 4 2014 <br /> EN1'RMMSE; EEALrH <br /> San Joaquin County <br /> Environmental Health Department <br /> I 1868 E . Hazelton Avenue <br /> Stockton , CA 95205 46p NSG t"WMq, y� <br /> Subject: CERTIFIED LIST OF RECORD FEE TITLE OWNERS FOR : <br /> SITE NAME : 1 <br /> ADDRESS : <br /> Complete # 1 if 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 Party: <br /> I , pmhi-C\`C Qk \ lytkrsswn R. I % N certify that the following is a <br /> complete list of current record fee title owners and their mailing addresses for the <br /> above site : ``ll <br /> `M� I�_ � <br /> �C Q CSC:N%( cv�.DL-u g <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 , t19m, 'b certify I am the sole landowner for the <br /> above site. <br /> Sincerely , <br /> Signature D46 - <br /> Revised <br /> Revised 12/ 15/09 <br />