Wastewater Survey Please return completed survey within thirty (30) days. A Federal and State requirement has been placed on this community to accomplish this inventory. Failure to submit a completed survey will be in violation of Union Gap Municipal Code Chapter 12. For assistance, please contact Jo Linder at jo.linder@uniongapwa.gov or 509.225.3524.Name of Business / Company(Required)Business Owner(Required) First Last Email(Required) Street Address of Facility Discharging Wastewater(Required) Street Address Mailing Address(Required) Same as Physical Address Different than Physical Address Mailing Address(Required) Address City State Zip Code Primary Phone Number(Required)Emergency Phone Number(Required)Brief description of business, principal products and services:(Required)Is this facility connected to the City's sewer system?(Required) Yes No I do not know Do you / will you discharge fats, oils or grease into the public sewer?(Required) Yes No Utility Account Number (if known)Based on your answers to the above questions, you may be asked to provide additional information to the City’s Wastewater Division.The information provided in this survey, is to the best of my knowledge true and complete.(Required) Yes No Signature(Required)Date(Required) MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.
