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'art a.OPERATOR INFORMATION(For disposal site,It operator is different from land owner,attach lease or ocher agreement] <br /> YPE OF BUSINESS: PARTNERSHIP ®CORPORATION []GOVERNMENT AGENCY <br /> ]SOLE PROPRIETORSHIP ® <br /> SSN OR TAX ID p <br /> WC-1UTY OPERATORS) <br /> Nam=): 941544481 <br /> Forward, Inc. <br /> TELEPHONE N <br /> kDDREsa CITY,STATE,ZIP 209-982-4298 <br /> 209-982-1009 <br /> L ADOWS& <br /> 9999 S.Austin Road, Manteca,CA 95336 dli htiel rW&r'=rvices.Corrl <br /> ONT C (Pnrd Name); <br /> Don Litchfield <br /> ADDRESS WHERE LEGAL NOTICE MAYBE SERVED <br /> 9999 S.Austin Road,Manteca,CA 95336 <br /> Part 9.SIGNATURE BLOCK <br /> Owner, <br /> I certify under penalty of perjury that the Information I provided for itis apprication and for any attachments is true and accurate to the best at my knowledge and beilef. I <br /> la specified above pursuant this application and understand that I may be responsible for the <br /> am aware that the operator Intends to operate a soft waste facility at the si <br /> site should the o allappllcable requirements, <br /> gZ(LA]DER�ORAGENT�V <br /> Kevin Basso <br /> PRINTED NAME <br /> General Man er <br /> DATE: <br /> TITLE: 3 <br /> Operator: <br /> he Information contained in this application and an attachments are true and accurate to the best of my knowledge and belle <br /> f. <br /> certify under penalty f perjury that tL <br /> �REI(FACIUTY;TRATOROR AGENT): <br /> Kevin Bassa <br /> PRINTED NAME _ !� <br /> General Ma er DATE: / <br /> WIE <br /> Part 10.OTHER (Attach additional sheets to explain any responses that need clarification), <br /> Paf3e 4 <br />