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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 PARTNERSHIP <br />FACILITY OPERATOR(S) <br />(Name): <br />San Joaquin County Department of Public Works (Solid Waste <br />ADDRESS, CITY, STATE, ZIP <br />1810 E Hazelton Avenue, Stockton CA 95201 <br />Part 9. SIGNATURE BLOCK <br />❑CORPORATION X❑GOVERNMENTAGENCY <br />SSN OR TAX ID #: <br />6800-14563 <br />TELEPHONE #: <br />209468-3066 <br />Bahadori <br />Owner: <br />I certify under penalty of perjury that the information I provided for this application and for any attachments is true and accurate to the best of my knowledge and belief. I <br />am a e 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 <br />tW site shtku IdAt op rator fail et applicable requirements. <br />e t"�' V <br />SIGNATURE (LAND OWNER OR AGENT): <br />PRINTED NAME: DesiReno <br />TITLE: Integrated Waste Manager DATE: <br />/2 4/45 <br />Operator: ?. <br />I certify under penalty o!,perjury tt}at 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: DesiReno <br />TITLE: Integrated Waste Manager DATE: V\ Ili <br />Part 10. OTHER (Attach additional sheets to explain any responses that need clarification). ` <br />Lovelace Permit Review 2015 Printed 2/23/2015 <br />