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Date of Spill: <br />Substance Spilled: <br />Quantity Spilled: _ <br />Location of Spill: _ <br />How estimated: <br />Did the spill enter any watettivays? Yes No <br />If yes, which waterways? <br />Who was the spill reported to: When: <br />Describe the cause of the spill: <br />Describe the cleanup/treatment of the spill (include times and quantities): <br />Where was the contaminated material taken (include times)? <br />How can similar spills be avoided in the future? <br />Copies to: <br />Environmental Engineer <br />Reported by Supervisor Department Manager <br />Mine Manager <br />Blue Mountain Energy, Inc. <br />Spill Report Form <br />Time of Spill: <br />