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RECEIVE <br /> JUL 31 2014 <br /> i <br /> ENVIRONMENTAL HEALTH 'y <br /> PERMIT/SERVICES <br /> ' f <br /> San Joaquin County <br /> Environmental Health Department <br /> 1868 Hazelton Ave _ <br /> Stockton, CA 952056232 —- <br /> Subject: CEE��IF(iwD f_lS-i OI+ I-, RD- -FEE ���W�D FC <br /> Ife <br /> SITE NAME: <br /> ADDRESS: ill a , , _Sy.t- <br /> Complete ti 1 if there are multiple site landowners. <br /> Complete fe: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 /> I'alme of prionaby Oh-Active Responsible Pavvm <br /> 1, —AA k I d—4 'A, �jif that the following is a <br /> complete list of current record fee title owners and their mailing addresses for the <br /> above site: <br /> 2. In accordance with-Section 25297.15(a) of Chapter 6.7 of the Health a°: Safety,Code: <br /> Mania of Responsible P,161-y: <br /> lo certify I am the se4e landowner for the <br /> above site. <br /> Sincerely, <br /> 8lure QGL(' <br /> Sigil <br />