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§18245 B f .YS CALIFORNIA CODE OFREG Aw 3 Title 14e--� <br /> The parties below certify and sign under penalty of perjury that the information its this document is true and correct to the best of his <br /> or her itnowledgei and that this document is being executed in accordance with the requirements of Tide 14, California Code of — <br /> Regulations,Division 7,Chapter S,Article 3.3,Section 18237. <br /> C>peratot's Signa Tide <br /> Solid Waste Manager <br /> Typed or Printed Name of Person Signing Date <br /> /2 — ZCf- 92 <br /> Tom Horton <br /> Risk Manager's Signature Tide v <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 under Tide 14,California Code of Regulations, <br /> Division 7,Chapter S,Article 3.3, Section 18237 in order to verify adequate timaneial assurance of solid waste disposal facilities. <br /> Completion of this form is mandatory. The consequence of not completing the foam is denial or revocation of a permit to opetate a solid <br /> waste disposal facility. Information may be provided to the US.Environmental Procection Agency,State Attorney General,Air <br /> Board, Cali(omia Department of Toxic Substances Control, Energy Resources Cccservation and Development CommissiM Water <br /> Resource Control Board,and California Regional Water Quality Control Boards. Farmore information or access to your records,contact <br /> the California Integrated Waste Management Board, 8800 Cal Center Drive,Sacramento,California 95826, (916)2SS-2200. <br /> CWM3133 tlM) tie Z ort <br /> Page 786 91—.x=15-17.4.24-92 <br />