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' Cripple Creek & Victor Gold Mining Company <br />Internal Spill Report <br />' E'tovtde ®ruedtate verbaE nohtiwtion to ER}3 if aspt3f 25 gallons nr more occurs to Isudar if ANl~ spi)3-amount <br />titters to sncfacewaterways or to ditches,leadinig to surface waterways <br />' Spills S4 ~ltaus or mare w land ai aup amauutta waretwags requires complenng, and presviding to ERDpersonnet <br />.this mterrtaE spr7l report before the end afshift m whah spilt occurred. ? <br />' eantaetERD dunng brismess hours-uatng CC3rV exrensrons Between 5 tN1 pm aad7 tl#? am ru vn weekenc3slhnltdays, <br />GoufactPhit Heroes 6&6.0395,'f mim Carver 686-3$~i.7eff pbelt or Lawrence Myers b89-2352 <br />,: <br />SPILL INFORMATION <br />' Date of Spill: Time of Spill: <br />Substance(s) Spilled: <br />' Concentration of Substance(s): <br />Quantity Spilled: How estimated: <br />Location of Spill: <br />' Did the spill enter any waterway{s) or ditch(es) to a waterway? Yes No <br />If yes, which waterways or ditches? <br />' Who was the spill reported to: When: <br />' Ir'1(;IJOfiO[] Vy JuFlei visui uepai miem nnannye~ ~ <br />