2012-05-17_PERMIT FILE - C1981012 ‎(2)‎

• Permit No: C1981012
• IBM Index Class Name: Permit File
• Doc Date: 5/17/2012
• Section_Exhibit Name: EXHIBIT 27 SPILL PREVENTION CONTROL AND COUNTERMEASURE PLAN
• Media Type: D
• Archive: No

April 2012
APPENDIX H
DISCHARGE NOTIFICATION FORM
Page H -1
Part A— Discharge Information
General information when reporting a spill to outside authorities:
Name: New Elk Coal Company
Address: 12250 Highway 12
Weston, CO 81091
Telephone: [phone]
Owner /Operator: New Elk Coal Company
122 West First St.
Trinidad, CO 81082
Primary Contact: Ron Thompson, Mine Superintendent
Work: 719- 845 -0090
Cell 24 hrs : 719 - 859 -0111
Type of oil:
Discharge date and time:
Quantity released:
Discovery date and time:
Quantity released to a waterbod :
Discharge duration:
Location/source:
Actions taken to stop, remove, and mitigate impacts of the discharge:
Affected media:
• Air ❑ Stormwater sewer/POTW
• Water ❑ Dike /berm/oil -water separator
• Soil ❑ Other:
Notification person:
Telephone contact:
Business:
24 -hr:
Nature of discharges, environmental /health effects, and damages:
Injuries, fatalities, or required evacuations?
SPCC
MR 115 Page 27 -48 Rev. May 2012