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Colorado Department of Public Health and Environment <br />Water Quality Control Division <br />Incident / Spill / SSO Release Reporting <br />Five (5) Day Reporting Form <br />C <br />Actual or estimated dates and times of the event, including duration and actual date and time spill was fully <br />controlled/stopped. If release is still occurring, the date and time the release is expected to be stopped. <br />Response: October 30, 2013 at approximately 4:15 a.m. Release continued for aproximately 1 hour. Spill was <br />fully controlled and stopped at approximately 5:30 a.m. on October 30, 2013. <br />D <br />Location of release (e.g., address, lat/long, road name and mile marker). <br />Response: The Henderson Mine address is1746 County Road 202 Empire, CO 80438. The spill took place near <br />the Mine exaust shaft #5, in the so- called No Name Gulch. <br />E <br />Describe measures taken or planned to contain, reduce, and clean up spill or release. <br />Response: Absorbant booms were placed under the, spill area and downstream. Impacted snow was removed <br />from the creek bed and disposed of. <br />F <br />Steps taken or planned to prevent reoccurrence of the event. <br />Response: Currently developing corrective and preventive actions. Potential actions include reducing areas <br />where snow plow needs to back up, installing delineators, barriers and /or berms along creek channel, as well as <br />additional review and training on operating procedures. <br />Incident Impact to State Waters (As defined in § 25- 8403(19), C.R.S.). <br />Examples of State waters include. perennial streams, intermittent or ephemeral gulches, ditches, ponds, lakes, reservoirs, lMgatlon <br />canals, wetlands, stonnwaterconveyances when they discharge to surface water, and groundwater <br />G <br />Did flow or materials reach surface waters of the State? If so, please describe the path of flow to State waters and which <br />State water body was impacted (e.g., spill impacted a storm drain which was directly connected to Cherry Creek, Colorado <br />River, etc.. If yes, what quantity of material e.. , gallons reached the surface water and what was the resulting impact? <br />Response: The exact quantity of the spill and amount that entered State waters is unknown, however Henderson <br />estimates that less than one half gallon of diesel fuel was spilled, with some of that quantity entering waters and <br />some contained in the snow or absorbant booms. The spill occurred in the so- called No Name Gulch, which is a <br />small tributary to the West Fork of Clear Creek. No impacts to the water is thought to have occurred. <br />H <br />Were any water quality samples or other samples taken? If so, please describe sampling process and attached results. <br />Response: No <br />I <br />Did flow or materials reach groundwater of the State? If so, please describe the path of flow to State waters and which State <br />water body impacted (e.g, spill soaked into ground and wet soil was not excavated). If yes, what quantity of material (e.g., <br />gallons) reached the ground or groundwater and what was the resulting impact? <br />Response: No <br />J <br />Did the incident include any of the following (check if yes)? If so, please include additional details below. <br />❑ Toxic Chemical Release <br />❑ Fish Kill <br />Response: No <br />Incident Impact to Areas or Water Users <br />K <br />Did the incident / spill / SSO impact any areas (e.g., public use areas including parks or swim beaches) or downstream water <br />users (e.g., public water suppliers, irrigation diversions)? Please list impacted areas and /or users, their location, and <br />potential impacts. <br />Response: None expected due to small quantity of release and distance to downstream users. <br />L <br />How were the impacted area users (e.g., park patrons) and downstream water users notified (e.g., signs posted, list <br />downstream users contact via phone). <br />Response: Called Clear Creek County Dispatch to implement Code Red Alert for downstream water users. <br />Revised November 2012 <br />Incident Reporting Hotline 1- 877 -518 -5608 <br />Page 2 of 3 <br />