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+ FREED & GAPPER DDS __________________________________ SiteID: 015-021-002329 +
Manager BusPhone: (661) 322-8815
Location: 1735 28TH ST Map 102 CommHaz Minimal
City BAKERSFIELD Grid: 24D FacUnits: 1 AOV:
CommCode: BFD STA Ol SIC Code:8021
EPA Numb: DunnBrad:
+______________________________________________________________________________t
Emergency Contact / Title Emergency Contact / Title
H KATHLEEN FREED / DDS RICHARD L GAPPER / DDS
Business Phone: (661) 322-8815x Business Phone: (661) 322-8815x
24-Hour Phone ( ) - x 24-Hour Phone : ( ) ~ - x
Pager Phone ( ) - x Pager Phone (~6/ ) 3m°J -3233 x
Hazmat Hazards: React
Contact r -rn nr1.TT1.Tn~7Tr * /Z~ca-lAn~ GgPP~2 DtJS Phone: (661) 322-8815x
MailAddr: 1735 28TH ST State: CA
City BAKERSFIELD Zip 93301
Owner FREED & GAPPER DDS Phone: (661) 322-8815x
Address 1735 28TH ST State: CA
City BAKERSFIELD Zip 93301
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
~ Emergency Directives: ~
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PROG H - HAZ WASTE GEN ~v a.
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Based on my inquiry of those individuals
responsible for obtaining the Information, I certify
under penalty of law that I have
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and am familiar with the information ~
submitted and believe the information is true ~
,
accurate, and complete.
Signature Date
ENT'D J U L 2 5 2006
-1- 05/17/2006