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Part 8, OPERATOR INFORMATION (For disposal site, if operator is different from land owner, attach lease or other agreement) TYPE OF BUSINESS: SOLE PROPRIETORSHIP PARTNERSHIP CORPORATION El GOVERNMENT AGENCY FACILITY OPERATOR(S) SSN OR TAX ID #: (Name): Mike Repetto #680293953 ADDRESS, CITY, STATE, ZIP TELEPHONE #: 30703 S . MacArthur Drive, Tracy , CA 95376 (209) 835.0601 FAX #: (209) 835-7729 E-MAIL ADDRESS: mikerna.tdswm . com CONTACT PERSON (Print Name): Mike Repetto ADDRESS WHERE LEGAL NOTICE MAY BE SERVED: 30703 S. MacArthur Drive, Tracy , CA 95376 Part 9. SIGNATURE BLOCK Owner: Mike Repetto 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 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 site should the operator fail to meet applicable requirements. SIGNATURE ( LAND OWNER OR A PRINTED NAME: Mike Repetto TITLE: Director DATE: f Lessee : nla JAr/v 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 am aware that the operator intends to operate a solid waste facility at the site specified above pursuant to this application. SIGNATURE (LESSEE): PRINTED NAME: - TITLE: DATE: Operator: Mike Repetto 1 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. SIGNATURE ( FACILITY OPERATOR OR AGENT): PRINTED NAME: Mike Repetto TITLE: Director DATE: r � T Part 10. OTHER (Attach additional sheets to explain any responses that need clarification) . J J Page 4