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Environmental Health - Public
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3500 - Local Oversight Program
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PR0545680
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
7/23/2020 2:14:33 PM
Creation date
5/20/2020 12:59:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545680
PE
3528
FACILITY_ID
FA0005535
FACILITY_NAME
THIEMANS SERVICE
STREET_NUMBER
106
STREET_NAME
SECOND
STREET_TYPE
ST
City
RIPON
Zip
95366
CURRENT_STATUS
02
SITE_LOCATION
106 SECOND ST
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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EnviroPacific <br /> P.O.Boz 1053,Vacaville,CA 95696,(707)447.2106 <br /> GEC Ua No A876019 <br /> . enviropaac@sboglabal.net <br /> NON-HAZARDOUS WATER DISPOSAL DOCUMENT <br /> GSITE <br /> ENERATOR <br /> Name: Envho Pacific ` ' + Name:' Enviro Pacific-Van? <br /> Address: P.O.Box 1063,Vacaville,CA 95698 - Address: 4960 Allison Parkway,Unit I,Vacaville,CA 95688 <br /> Contact Brennan Mahoney w_:TeL (707)761-2306 Contact Brennan Mahoney Tei: (707)761-2306 <br /> ttA 1 _ <br /> i DESCRIPTION. <br /> Description of Water. Purged groundwater and equipment water <br /> ed <br /> Quantity J 00 Units: gallons .> <br /> 'S <br /> This non-hazardous waste water Is Purged groundwater,auger rinse water,sampling equipment rinse water,a combination thereof,or as <br /> described above. The described water may contain hydrocarbons. I Certify that the above named material has been Property described and <br /> classified according to applicable regulations and possesses no characteristics that would require its handling as a hazardous waste. <br /> - r•I C71 <br /> Generator/Aumorizetl Agent. V .. ��1 �; <br /> Print Na WTdIe Sign Date <br /> Name: Frank's Septi:Services.Ina Name: EBMUD <br /> Address: P.O.Bop 1477,Vacaville,CA 95696 Address: 2020 Wake Avenue,Oakland,CA <br /> Tel: (707)6784041 <br /> Waste Dis Number FR813000-024 <br /> 4 Q <br /> Driver: ( -`�Rr'rfj EP Waste Tradting No: 1022 .W4,g4; Removal Date I <br /> r <br /> Sign Date Received <br /> i <br /> 6m6vPaeNRe <br /> r . <br />
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