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Part 8. OPERATOR INFORMATION (For dispos site, if operator is different from landowner, attach lease o her agreement) <br />TYPE OF BUSINESS: <br />❑SOLE PROPRIETORSHIP <br />FACILITY OPERATOR(S) <br />(Name): <br />, CITY, STATE, ZIP <br />PARTNERSHIP CORPORATION ®GOVERNMENTAGENCY <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 />s�e�c�gtt7dthe up�rofallgfo meet �ppl+cabi <br />SIG UR { ND WNE R AGENT): <br />PRINTED NAME: Desi Reno <br />TITLE: Integrated Waste Manager <br />SSN OR TAX ID #: <br />TELEPHONE #: <br />209-468-3066 (Solid Waste <br />FAX #: <br />209468-3078 (Solid Waste <br />E-MAIL ADDRESS: <br />mcarroll@sjgov.org <br />CONTACT PERSON (Print Name): <br />W. Michael Carroll <br />I provided for thls'appllcatlon and forany attadhtrtenfs Is true and accuratetQ fire bes(bf my k�bw(edge andeilef I„ <br />ivias#e:fact lity at the site"§peClfied above puisuant tq ttsls appltca'fron andind�r5tand that 1 maybe�esponsitiie:for <br />qultem nts. <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 />