Spill - Template

Metro Park East Sanitary Landfill - 318509689

12181 12th Ave NE Mitchellville, IA 50169

Polk County

FO 5

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Spill Number:

101309-AHB-1456

Spill Location:

41.600000, -93.340000

Spill County:

Polk

FO 5

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
Rebecca Nott	FO	Regulatory Contact
	Appliance Demanufacturing	Legally Responsible Entity
Metro Waste Authority	Municipal Landfills	Legally Responsible Entity
Metro Waste Authority	Municipal Landfills	Legally Responsible Entity
Iowa DNR	Municipal Landfills	Legally Responsible Entity
HDR Engineering, Inc.	Municipal Landfills	Legally Responsible Entity
Andrew Phillips	Municipal Landfills	Legally Responsible Entity
ARTHUR KERN	General Permit #1 - Industrial Activity	Public Contact
ANDREW PHILLIPS	General Permit #1 - Industrial Activity	Public Contact
METRO WASTE AUTHORITY	General Permit #1 - Industrial Activity	Legal Operator
METRO WASTE AUTHORITY	General Permit #1 - Industrial Activity	Owner

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
10/14/2009	Landfill employees placed wood chips and oil dry on the spill and recovered contaminated materials. Contaminated materials will be disposed of at the landfill.	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

Metro Park East Sanitary Landfill - 318509689

12181 12th Ave NE Mitchellville, IA 50169

Polk County

FO 5

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Incident Report

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Material Information

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Possible Facility

Public Water Supply: Surface Water