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Water Pollution Control
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Bob Sample
, WPC Superintendent
1115 NE Poplar Street
Topeka, KS 66616s
785-368-3111 Tel
785-368-3855 FAX
rsample@topeka.org
Water Pollution Control Contacts
Water Pollution Control Division
Interceptor Service Inspection Sheet
Quarterly Report
Licensed Grease Haulers
Please indicate the month that corresponds to the end of the quarter for which this report is being submitted
:
March
June
September
December
Facility Name:
Street:
City:
State:
Zip:
Designated Facility Contact:
Name:
Title:
Telephone Number:
Grease Hauler Name:
Telephone number:
Have any repairs been made to the grease interceptor/trap?
Yes
No
Dates of interceptor/trap cleaning
Volume of liquids/solids removed (size of interceptor/trap)
Method of Disposal (i.e., trash receptacle, land application, treatment plant discharge)
Your e-mail address: (optional)
Last Updated
: Thursday January 03 2008
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