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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 />MOLE PROPRIETORSHIP PARTNERSHIP CORPORATION EIGOVERNMENTAGENCY <br />FACILITY OPERATOR(S) SSN OR TAX ID #: Q <br />(Name): \_S' 1 � OLX- \)�8� — �i � r o Q T-) r) �j J � / _l o 3 4 U <br />CITY, STATE, ZIP <br />Q CSC <br />TELEPHONE 9: <br />foci •';q <br />FAX #: <br />.V , - —1 0 / vJclJ <br />-MAIL ADDRESS: I\, <br />UNTACT PERSON (Print Name): <br />ADDRESS WHERE LEGAL NOTICE MAY BE SERVED: <br />. ar) M (D nGecs/4ar v��-��oeo�er 1�'f �l r.�. C-�1�P�,5}�te 81y.Q_ Fr-zsr'rD <br />Part 9. SIGNATURE BLOCK <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 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&ND OVVAER OR AGENT): -- <br />ex-_> Yh <br />q3) a a <br />Operator: <br />I 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 <br />PRIN I EU NAME // <br />TITLE: DATE: <br />Part 10. OTHER (Attach additional sheets to explain any responses that need clarification). <br />CONI=IDLNTUL <br />Page 4 <br />