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02/10/03. 15:11 FA% 970 353 2147 RCI <br />_.,~, . - CUF'HE-ll6)CD Fax:303782U39G <br />apartment of public Health end Environment <br />ality Control Divlalon <br />Jae 15 2003 10:15 P. O1 . <br />SPILL REPORT <br />Cool <br />caue~/Incident Inrormation <br />data i;l sW:teC Time .Qua, ' Rekaae0 Draxitior ' ,~ Ra sd ~ CeliOdck~ numenr ~: , ,Ccun <br />t3st tTJ03102 3:00 PM Es:.t~ al. 1 Dehrafilandon 97P'30~•t34;S ~ Weld <br /> <br />7 Of 5 li CtIKk One): ~ ~ Check all thdt a I & filet ncyrce;brte :n "Dthdr.COrninwn(S" t161pW <br />^ Sanitary Sewn Overflow (550) <br />^ Ww 7reatmen0 Piant Bypass or Upset <br />~ Petroleum Product <br />^ Chemimi <br />^ i;ombirxd Sewer Overflow <br />l1- Siasdids <br />^ d ha SP'~II ^ Toxic - <br />O Surface Waters Impeded - <br />^ Rsh lail <br />^ Cowmatream DW Suppliers Notl6ed <br />^ Down~pm IMSators NdMed <br />^ Other Users or Eneda Natlfied . <br />[J Samples TakM ~ <br />LIItytititl~t~dfRYY ~ r:4- - <br />Hiner NOnh Laka/222C Went 0 Street, OrsNsy, CO ' <br />Ras sible Entity Intom+ation <br /> <br />~' .F.,r .'.. .~2t~ ~ n :t~~ <br />,~tt if ~ ~ c..::w~;,::~~- ~d ~ 1 <br />~ ~ <br />~ <br />GAIT` ~ ~ Ti'ptttber <br />Centel Sand and DrrvW ? <br />Gene 6foklmt <br />ier 402.69-8828 <br />]rjy_ <br /> <br />I <br />N.rA <br />l <br />- ' r. ., ' ,~ .,. <br />a<'. <br />prt; q <br />, <br />GpniafnEn3ted soile (eat. 2000 CY) exrawted.snd alockp0atl bohind CCMainme I <br />can on•aite. M6tariak will Da dletrlbuted and windrowed en-skein Sprlnp of <br />N/A ' <br />2E08 before bNn9 procasPad thratgh send and gavel oppra0cr. Exoevelion <br />filled with dean, Cn-site materWP to alpinal grade. <br /> <br />IniOal reeOrt reaeWed from EmaNOneY Matgpomant Prcpram on 1?/DDI02 with , <br />several fotlow-up tNephone conversaBOn wire Oane end Ron Richardcon (RCI) <br />rapartling dan-up eSeb. Product apparer+tty roleased hcm an abovegreund <br />SANege tank as a rexult of v8ncaliesT. A'ihCUgA Oflgtinai roport irdiCated 4sM hatl WA <br />bean kiAed, nobody apparently wilneassd dead fish at errs. Protluet wee as off• , <br />road dfeaN product which is colored wMA a red dye. No apparard product an <br />ureter or emCenkrnents owed upon t2/l7/02 sRe visit <br />InigPlt <br />X <br />INTERNpI USE ONLY <br />Adegvrete <br />[J Follnv L% Requi"v1 ~ Si6e tTrit NaaaW C 0.0Rrrsd for Enforcement <br />d2121e Report..de ~ DRAFT o.4rY001 <br />