HomeMy WebLinkAbout1620 e brundage _envirotech report 6.22.20_19-240 � 4S 0
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C A L I F 0 R N 1 A
Water Boards
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GAVIN NEWSOM
GOVERNOR
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` % .JARED BLUMENFELD
k*�;;ENVIRONMENTAL FOR
ENVIRONMENTAL PROTECTION
State of California
Regional Water Quality Control Board
APPLICATION /REPORT OF WASTE DISCHARGE
GENERAL INFORMATION FORM FOR
WASTE DISCHARGE REQUIREMENTS OR NPDES PERMIT
I. FACILITY INFORMATION
A. FACILITY:
Name Coles Environmental Services, Inc.
Address 1620 East Brundage Lane
City /County /State /Zip Code Bakersfield, California 93307
Contact Person Ben McNiell
Telephone Number 661- 322 -8258
B. FACILITY OWNER:
Name Coles Environmental Services, Inc.
Address 1620 East Brundage Lane
Email ben @colesenvironmental.com
City /State /Zip Code Bakersfield, California 93307
Contact Person Ben McNiell
Telephone Number 661- 322 -8258
Federal Tax ID
Owner Type (Mark one):
F1 Individual Z Corporation
F1 Other
Email ben @colesenvironmental.com
E]Governmental Agency F]Partnership
C. FACILITY OPERATOR (The agency or business, not the person):
Name Coles Environmental Services, Inc.
Address 1620 East Brundage Lane
City /State /Zip Code Bakersfield, California 93307
Contact Person Bryan Hill
Telephone Number 661 - 978 -0680
Operator Type (Mark one):
[—]Individual ZCorporation
F-]Other:
Email bryan @colesenvironmental.com
[:]Governmental Agency E]Partnership
Form 200 (10/97) 1