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U <br />AUTHORITY: Public Resources Code section 43800 at seq, <br />PURPOSE: The information provided will be used to verify adequate financial assurance of solid waste <br />disposal facilities listed. <br />REQUIREMENT: Completion of this form Is mandatory. The consequence of not completing this form is <br />denial or revocation of a permit to operate a solid waste disposal facility. <br />OTHER INFORMATION: After review of this document, you may be requested to provide additional <br />Information regarding the acceptability of this mechanism. <br />ACCESS: information provided in this form may be provided to the U.S. Environmental Protection <br />Agency, State Attorney General, Air Resources Board, California Department of Toxic Substances <br />Control, Energy Resources Conservation and Development Commission, Water Resources Control <br />Board, and California Regional Water Quality Control Boards. For more Information or access to your <br />records, contact the Calgornla Integrated Waste Management Board, 8800 Cal Center Drive, <br />Sacramento, CA 95826. (916) 255=2200. <br />CA SOLID WASTE -CPC (1/00) Page 3 <br />CIWMB 106 (4/96) <br />