220 E Mountain View St. Ste A Barstow, CA 92311 (760) 255-5161 https://www.barstowca.org/home
BARSTOW CANNABIS FACILITY
ON-SITE MEMBER CONTACT STATEMENT
The undersigned, on behalf of ____________________________ (Name of Corporation)
hereby designates ____________________________________ as the on-site (Name of On-Site Manager)
problems or issues relating to the Barstow Cannabis Facility. The Cannabis Facility shall make every good faith effort to encourage residents to call this person to try to solve operating problems, if any, before any calls or complaints are made to the Police or Planning Departments.
Signature of On-Site Manager Printed Name & Title
Address Phone Number
Fax Number Email
I declare under penalty of perjury that I have read the forgoing application and all information, statements, verifications, declarations, and authorizations made, attached to and contained herein, and that I have personal knowledge of the information contained in the application, and that the information contained and the application is true and correct, and that the application was completed under supervision of the Management Members.
Executed this ________________ day of ______________ 20______ in Barstow, California. (Day) (Month) (Year)
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