Laserfiche WebLink
182Aa- B. .YS CALIFORNIA CODE OF UL 3 Title 14� <br /> � <br /> The parties below certify and sign under penalty of perjury that the information%d is document is true and correct to the best of his <br /> or her knowledge, and that this document is being executed in accordance with tate requirements of Title 14, California Code of — <br /> Regulations,Division 7,Chapter 5,Article 3.3,Section 18237. .+ <br /> Cpctatoes signa Tide <br /> Solid Waste Manager <br /> Typed or printed Name of Person Signing Date <br /> f2 - z�- 9z <br /> Tom Horton <br /> Risk Manager's Signature Title <br /> Typed or Printed Name of Person Signing Date <br /> Richard Pietz <br /> PRIVACY STATEMENT <br /> This information is requested by the California Integrated Waste Management Board tinder Title 14,California Code of Regulations, <br /> Division 7,Chapter 5,Article 3.3, Section 18237 in order to verify adequate fimancial assurance of solid waste disposal facilities. <br /> Completion of Itis forth is mandatory. The consequence of not completing the forte is denial or revocation of a permit to operate a solid <br /> waste disposal facility. Information may be provided to the U S.Environmental Proa=tion Agency,State Attorney General,Air Resources <br /> Board, California Department of Toxic Substances Control, Energy Resources Conservation and Development Commission, Water <br /> Resources Control Board,and California Regional Water Quality Control Boards. Formom information or access to your records,contact <br /> the California Integrated Waste Management Board, 8800 Cal Center Drive,Saaa=xnuo,California 95826, (916)2SS-2200. <br /> tZvvMa 129(]t19t) Fag2of2 <br /> Pane 796 a.a 91-.%m 15-17:4.s92 <br />