2013-11-08_REPORT - M1977342

• Permit No: M1977342
• IBM Index Class Name: REPORT
• Doc Date: 11/8/2013
• Doc Name: Copy of CDPHE 5 day spill report as required by Section 3.1.13 of the Hard Rock Mining Regulations
• From: Henderson Mine
• To: DRMS
• Email Name: PSH
• Media Type: D
• Archive: No

Colorado Department of Public Health and Environment Incident / Spill / SSO Release Reporting
Water Quality Control Division Five (5) Day Reporting Form
Field Services — Grand Junction
County
Field Services — Pueblo
Incident / Spill Number (Division
Field Services — Denver
® 222 South 6th Street, Room 232
❑
4718 North Elizabeth St., Suite B
❑
4300 Cherry Creek Dr. South, B2
Grand Junction, CO 81501
Type of Incident / Spill / SSO
(check one)
Pueblo, CO 81008
E] Combined Sewer Overflow
Denver, Colorado 80246 -1530
Telephone: 970 - 248 -7150
Other
Telephone: 719 - 545 -4650
Contact Information
Phone: 303 - 692 -3650
Fax: [phone]
Potentially Responsible Party
Fax: 719 - 543 -8441
(PRP): Contact Name
Fax: 303 - 782 -0390
Contact email:
Contact email:
Contact email:
michelle.thiebauffistgte.co.us
I
I carol. keever state.co.us
PRP email address
annemarie.Qoolsby(a)state.co.us
Reporting Form: Incident I Spill I Sanitary Sewer Overflow (SSO)
The Division distinguishes between reporting requirements for spills that occur with respect to activities that result in a
discharge that is authorized under a CDPS permit and those that are not. Reporting and management of spills that occur
with respect to activities resulting in a discharge authorized under a permit should be performed in accordance with the
specific requirements of that permit. If the permit does not require a 5 -day report, please provide the information below in
writing. For non - permitted activities, or in the case of an activity where a permit does not address reporting of or response
to a given spill, please submit this written response to the Water Quality Control Division within five (5) working days of the
date of the event. If sufficient space is not provided, please attach other sheets. Please send the completed form with
signature via fax or email to the Division's Field Services office indicated above. If you have any questions please contact
the Division's Field Services Engineer at your earliest convenience. The Field Services County list is available at:
http:/ /www.colorado.gov /cdphe /wqcd in the middle Services pane, select Inspection Services, then the Contact Us button.
Prior to the five (5) working day deadline, you may request an extension to submit the report if sample analyses justifiably
are going to require more time to analyze than the reporting time allows. To request an extension please send an email to
the Division's Field Services Engineer for the County that the incident / spill / SSO took place or to the email listed above.
Incident Background Information
County
Clear Creek
Incident / Spill Number (Division
2013 -0742 10/30/13
• rovided ) and Spill Date
Sanitary Sewer Overflow /Reuse
® Petroleum Product
Chemical
Type of Incident / Spill / SSO
(check one)
❑ WW Treatment Plant Bypass or Upset
throu h an authorized outfall point)
E] Combined Sewer Overflow
E] Biosolids
Unplanned potable water release e.g., water line break
Other
Contact Information
Potentially Responsible Party
Miguel Hamarat
Potentially Responsible Party
Climax Molybdenum
Company - Henderson
(PRP): Contact Name
(PRP): Company/ Agency
Operations
PRP Phone / Fax
Phone: [phone]
PRP email address
miguel_hamarat @fmi.com
Fax:
CDPS Permit Number:
C00041467
CDPS Permittee Name:
Climax Molybdenum
Company
Reported by (if not PRP):
Reported by (if not PRP):
Contact Name
Company/ A enc
Reported by (if not PRP):
Phone:
Reported by (if not PRP):
Phone / Fax
Fax:
email address
Incident Information: Please provide the following information.
A
Incident / spill / SSO source cause and event description.
Response: On October 30"', at approximately 4:15 a.m. an operator was backing up a snow plow near the so-
called No Name Gulch at the Henderson Mine when the right back dual tires went into ditch pulling the whole
truck into the ditch. The truck was leaning to the right towards the bank. The Mine surface crew was called to
the location and subsequently saw some fuel dripping from the fuel tank cap. They placed absorbent booms in
the creek downstream of the truck and under the truck where it was leaking. A tow truck was called to pull the
snow plow from the ditch. The snow in the area was then cleaned out of the creak to prevent any additional
fuel from entering the waterway and booms were re-positioned downstream to absorb any remaining diesel.
B
Material released (e.g., untreated wastewater, biosolids, specific chemicals or products) and estimated total quantity (e.g.,
gallons). Please attach MSDS for any and all chemicals or products involved ins ill or release.
Response: 91 Diesel
Revised November 2012 Incident Reporting Hotline [phone] Page 1 of 3