Spill - Template

John Deere Dubuque Works - 310201475

18600 S John Deere Rd Dubuque, IA 52001

Dubuque County

FO 1

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Spill Number:

032713-AHB-1026

Spill Location:

42.570000, -90.690000

Spill County:

Dubuque

FO 1

Incident Report

Received:

Received By:

Discovered:

Assigned To:

Reported By:

Anonymous

DNR Observation

Individual

Company:

Name:

Title:

Phone:

Email:

Incident Information:

Sec:
Tier:
Range: W
Lat:
Long:

Responsible Party

Remove Facility

Is Individual

Unknown

Company:

Phone:

Email:

Address:

City:

State:

Zip:

Spill Contact

Name:

Title:

Phone:

Email:

Address:

City:

State:

Zip:

Name	Program	Type
JOHN DEERE DUBUQUE WORKS	General Permit #2 - Construction Activity	Owner
SCOTT HEMESATH	General Permit #2 - Construction Activity	Public Contact
JAMES HENSLEY	General Permit #2 - Construction Activity	Public Contact
CHRIS SABERS	General Permit #2 - Construction Activity	Public Contact
JESSICA CORYELL	General Permit #2 - Construction Activity	Public Contact
JOHN DEERE DUBUQUE WORKS	General Permit #2 - Construction Activity	Owner
JAMES HENSLEY	General Permit #2 - Construction Activity	Legal Operator
JAMES HENSLEY	General Permit #2 - Construction Activity	Public Contact
CHRISTOPHER SABERS	General Permit #2 - Construction Activity	Public Contact
John Deere Dubuque Works	Title V	Public Contact
Jack Dallal	Title V	Public Contact
	Title V	Public Contact
	Title V	Public Contact

Material Information


Material: Medium: Quantity: Units:

Transportation:

Fish Kill:

Continuous Release:

Date of Investigation:

Incident Investigated:

Status:

Compliance Determination:

30 Day Report Not Expected

Transferred To Contaminated Sites:

Report

Attached Files/Reports

File Name	File Type	File Date	Note

Comments

Date	Comment	Commenter
3/27/2013	John Deere facility staff placed boom in river to contain sheen. Staff are investigating source, cause, and volume released. They will handle cleanup of material.	ADAM BROUGHTON

Comment:

Public Water Suppliers

Name	Supply Type	PWS ID	Operator: Name / Phone Number	Contacted

Compliance Tracking

Action Type	Date	Completed Date	Comment	Delete

Multiple Results Found

Field Office Compliance - Spill

New Material

John Deere Dubuque Works - 310201475

18600 S John Deere Rd Dubuque, IA 52001

Dubuque County

FO 1

Edit Facility Location

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Facility Note

Incident Report

Responsible Party

Material Information

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Public Water Suppliers

Compliance Tracking

Possible Facility

Public Water Supply: Surface Water