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� a <br />eee® e <br />Part 8. OPERATOR INFORMATION (For disposal site, if operator is different from land owner, attach lease or other agreement) <br />TYPE OF BUSINESS: <br />RSOLE PROPRIETORSHIP PARTNERSHIP CORPORATION ®GOVERNMENT AGENCY <br />FACILITY OPERATOR(S) <br />(Name): <br />CITY, STATE, ZIP <br />Department of Public Works <br />Attention Solid Waste Division <br />PO Box 1810, Stockton CA 95201 <br />ADDRESS WHERE LEGAL NOTICE MAY BE SERVED: <br />1810 East Hazelton Way, Stockton CA <br />Part 9. SIGNATURE BLOCK <br />Owner: <br />SSN OR TAX ID #: <br />1 ELEPHONE #: <br />209-468-3066 (Solid Waste Division <br />FAX #: <br />209-468-3078 (Solid Waste Division <br />E-MAIL ADDRESS: <br />mcarroll@sjgov.org <br />CONTACT PERSON (Print Name): <br />W. Michael Carroll <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 awa€e #hat 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 />4hci eNa efrrritirl fk.—m'—fnr fail fn magi nnnli—Kla%ranniramonfa6, <br />SIGNATURE <br />0, <br />PRINTED NAME: Desi Reno <br />TITLE: Integrated Waste Manager <br />Operator: <br />hcertify undee 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 />SAME AS ABOVE <br />SIGNATURE (FACILITY OPERATOR OR AGENT): <br />SAME AS ABOVE <br />PRINTED NAME: <br />SAME AS ABOVE <br />TITLE: SAME AS ABOVE DATE: <br />Part 10. OTHER (Attach additional sheets to explain any responses that need clarification). <br />Page 4 <br />