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Part B.OPERATOR INFORMATION(For disposal site,if operator Is different from landowner,attach lease or other agreement) <br /> TYPE OF BUSINESS: <br /> ®SOLE PROPRIETORSHIP DPARTNERSHIP EX CORPORATION ®GOVERNMENT AGENCY <br /> FACILITY OPERATORS) SSN OR TAX ID#- <br /> (Name); <br /> Forward, Inc. 941544481 <br /> ADDRESS,CITY,STATE,ZIP TELEPHONE N <br /> 209-982-4298 <br /> FAX 1; <br /> 209-982-1009 <br /> 9999 S. Austin Road, Manteca,CA 95336 E-MA L ADDRESS <br /> E Fanning@ republicservices,corm <br /> CONTACT PERSON(Print Name): <br /> Erin Fanning <br /> ADDRESS WHERE LEGAL NOTICE MAY BE SERVED. <br /> 9999 S.Austin Road,Manteca,CA 95336 <br /> Part 9.SIGNATURE BLOCK <br /> Owner: <br /> I certify under penalty of paqury that the Information t provided for this application and for any attachments is true and accurate to the best of my knowledge and belief I <br /> am aware that the operator intends to operate a solid waste facility at the site specified above pursuant to this appi cation and understand that I may be responsible for the <br /> site should the operator fail to meet qppffbable requirements. <br /> SIGNATUPF(LAND OWNE"R'OR AGENT) <br /> Kevin Basso <br /> PRINTED NAME: <br /> General Manager <br /> TITLE: DATE <br /> Operator: <br /> I certify under pen t4—pajury_tharrhe information contained in this application and all attachments are true and accurate to the best of my knowledge and belief. <br /> SIPK'A,TIAE(FAC!V6 OPERATOR OR AGENT) <br /> Kevin Basso <br /> PRINTED NAME: <br /> General Manager <br /> TITLE: DATE- <br /> Part 10.OTHER (Attach additional sheets to explain any responses that need claillication). <br /> Page 4 <br />