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Part 1 —ADMINISTRATION continued <br /> B. Project Manager Information. Ecology will send this person all official correspondence. This <br /> person must either be the Customer or be employed by the Customer. This person may not be an <br /> independent contractor hired by the Customer. Please enter the required information below. <br /> Name: Mike Palacios Title: Real Property Manager <br /> Mailing address: 3200 Cedar Street <br /> City: Everett State: WA Zip: 98201 <br /> Phone: 425-257-8938 Fax: E-mail: mpalacios@everettwa.gov <br /> C. Project Billing Contact Information. Ecology will send this person monthly invoices. This person <br /> must either be the Customer or be employed by the Customer. This person may not be an independent <br /> contractor hired by the Customer. Please enter the required information below. <br /> Name: Mike Palacios Title: Real Property Manager <br /> Mailing address: 3200 Cedar Street <br /> City: Everett State: WA Zip: 98201 <br /> Phone: 425-257-8938 Fax: E-mail: mpalacios@everettwa.gov <br /> D. Project Consultant Information. <br /> Is the Customer a consultant? <br /> ❑ Yes If you answered "YES,"then skip to the next question. <br /> ® No If you answered "NO" and the Customer hired a consultant to conduct the <br /> independent remedial action, then enter the required information below. <br /> Name: Jacob Letts LG and Dana Carlisle PE Title: Project Manager, Principal <br /> Organization: GeoEngineers <br /> Mailing address: 1101 South Fawcett Avenue <br /> City: Tacoma State: WA Zip: 98402 <br /> Phone: 253-722-2419 or 425- Fax: E-mail: jletts(c�geoengineers.com <br /> 861-6000 dcarlisle(c�geoengineers.com <br /> Do you want Ecology to contact the Project Consultant? <br /> ® Yes ❑ No <br /> E. Property Owner Information. <br /> Is the Customer the owner of the property where independent remedial action is being conducted? <br /> ® Yes If you answered "YES,"then enter the type of entity and skip to the next question. <br /> ❑ No If you answered "NO,"then please enter all of the required information below. <br /> Name: Michael Palacios Title: Real Property Manager <br /> Organization: City of Everett <br /> Mailing address: 3200 Cedar Street <br /> City: Everett State: WA Zip: 98201 <br /> Phone: 425-257-8938 Fax: E-mail: mpalacios@everettwa.gov <br /> ECY 020-74(revised May 2013) 2 <br />