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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 X CORPORATION GOVERNMENT AGENCY FACILITY OPERATOR(S) SSN OR TAX ID #: (Name): ADDRESS, CITY, STATE, ZIP TELEPHONE #: FAX #: E-MAIL ADDRESS: CONTACT PERSON (Print Name): ADDRESS WHERE LEGAL NOTICE MAY BE SERVED: Part 9. SIGNATURE BLOCK Owner: SIGNATURE (LAND OWNER OR AGENT): PRINTED NAME: TITLE: DATE: Lessee: SIGNATURE (LESSEE): PRINTED NAME: TITLE: DATE: Operator: SIGNATURE (FACILITY OPERATOR OR AGENT): PRINTED NAME: TITLE: Part 10. OTHER (Attach additional sheets to explain any responses that need clarification). General Manager DATE: I 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. Kevin Basso 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. Kevin Basso General Manager 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. Kevin Basso kbasso@republicservices.com (209) 982‐4298 Forward Inc. 9999 South Austin Road, Manteca, CA 95336 Page 4 65-0716904 03/14/2022 03/14/2022 03/14/2022