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Primary Contact <br />❑ Check here if the Primary Contact is the same as the Legal Contact above. <br />O By checking this box and signing below, I acknowledge my role as the primary contact for the designating <br />organization. <br />Name: Anthony Title: Cademarti <br />Telephone: (425) 257-8920 Email: TCademar@everettwa.gov Fax: <br />Signature: _ Date: <br />Organization Information <br />Organization is, or can be, registered in the CFS as a(n): <br />❑ Credit Generator <br />❑ Importer of Blendstocks <br />❑ Importer of Finished Fuels <br />Check boxes of fuels which will generate credits: <br />❑ Alternative jet fuel <br />❑ Clear gasoline <br />❑ Any blend of gasoline and ethanol <br />❑ Clear diesel <br />❑ Any blend of diesel and biodiesel or renewable diesel <br />❑ Biodiesel <br />❑ Ethanol <br />❑ Renewable diesel <br />❑ Renewable gasoline or its constituents <br />❑ Renewable naphtha <br />❑ Renewable propane <br />❑ Fossil CNG <br />ECY 070-714 <br />UM DEPARTMENT OF <br />ECOLOGY <br />State of Washington December 2022 <br />