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Part 8. OPERATOR INFORMATION(For disposal site,if operator is different from land owner,attach lease or other agreement) <br /> TYPE OF BUSINESS: <br /> SOLE PROPRIETORSHIP OPARTNERSHIP CORPORATION ❑GOVERNMENT AGENCY <br /> FACILITY OPERATOR(S) SSN OR TAX ID#: <br /> (Name): � ' <br /> MWCLdCA pcodue--& <br /> ADDRESS,CITY,STATE,ZIP D(� TELEPHONE#: <br /> ��• ,,ac K I �vn <br /> FAX#: <br /> S-ttc 0"10q t�4 Le <br /> E-MAIL ADDRESS: <br /> -�'Le 1 (no( i UU,Com► <br /> CONTACT PERSON(P Name <br /> Wae I dYY C <br /> ADDRESS WHERE LEGAL NOTICE MAY BE SERVED: <br /> Part 9.SIGNATURE BLOCK <br /> Owner: <br /> I certify under penalty of perjury that the informs n I provided for this application and for any attachments is true and accurate to the best of my knowledge and belief. I <br /> am aware that the operator intends to operate a solid waste facility at the site specified above pursuant to this application and understand that I may be responsible for the <br /> site should the operator fail to meet applicable requirements. <br /> SIGNATURE(LAND OWNER OR AGENT): <br /> PRINTED NAME: <br /> TITLE: <br /> DATE: <br /> Operator: <br /> 1 certify under penalty of perjury that the information contained in this application and all attachments are true and accurate to the best of my knowledge and belief. <br /> SIGNATURE(FACILITY OPERATOR OR AGENT): <br /> PRINTED NAME: <br /> TITLE: <br /> DATE: <br /> Part 10.OTHER (Attach additional sheets to explain any responses that need clarification). <br /> Page 4 <br />