Spill - Template

Ajinomoto Health and Nutrition North America, Inc - AHI - 310423788

1116 Highway 137 Eddyville, IA 52553-5001

Monroe County

FO 5

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Spill Number:

080702-CWO-0910

Spill Location:

41.145030, -92.649880

Spill County:

Monroe

FO 5

Incident Report

Received:

Received By:

Discovered:

Assigned To:

Reported By:

Anonymous

DNR Observation

Individual

Company:

Name:

Title:

Phone:

Email:

Incident Information:

Sec: 12
Tier: 73
Range: 16 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
AJINOMOTO U.S.A., INC.	General Permit #1 - Industrial Activity	Owner
AJINOMOTO HEARTLAND, INC.	General Permit #1 - Industrial Activity	Legal Operator
AJINOMOTO U.S.A., INC.	General Permit #1 - Industrial Activity	Owner
ROB SAUNDERS	General Permit #1 - Industrial Activity	Public Contact
DAVE SAMPLE	General Permit #1 - Industrial Activity	Public Contact
AJINOMOTO U.S.A., INC.	General Permit #1 - Industrial Activity	Owner
AJINOMOTO HEALTH AND NUTRITION NORTH AMERICA, INC.	General Permit #1 - Industrial Activity	Owner
MARK WILSON	General Permit #1 - Industrial Activity	Public Contact
TRACY WILLIAMS	General Permit #1 - Industrial Activity	Public Contact
DAVE SAMPLE	General Permit #1 - Industrial Activity	Public Contact
DAVE SAMPLE	General Permit #1 - Industrial Activity	Public Contact
DAVE SAMPLE	General Permit #1 - Industrial Activity	Public Contact
DAVE SAMPLE	General Permit #1 - Industrial Activity	Public Contact
DAVE SAMPLE	General Permit #1 - Industrial Activity	Public Contact
DAVE SAMPLE	General Permit #1 - Industrial Activity	Public Contact
ROB SAUNDERS	General Permit #1 - Industrial Activity	Public Contact
AJINOMOTO NORTH AMERICA, INC.	General Permit #1 - Industrial Activity	Owner
MARK WILSON	General Permit #1 - Industrial Activity	Public Contact
AJINOMOTO NORTH AMERICA, INC.	General Permit #1 - Industrial Activity	Owner
AJINOMOTO HEALTH & NUTRITION NORTH AMERICA INC	Water Use	Permittee
AJINOMOTO HEALTH & NUTRITION NORTH AMERICA INC	Water Use	Permittee
AJINOMOTO HEALTH & NUTRITION NORTH AMERICA INC	Water Use	Permittee
Ajinomoto Animal Nutrition North America, Inc.	Title V	Public Contact
Carl Haffner	Title V	Public Contact
Dave Sample	Title V	Public Contact
David Sample	Title V	Public Contact
	Title V	Public Contact
	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

Document Name	Type	File Date	Note
08-20-2015\080702-CWO-0910.pdf	Report		email and administrative order

File Name	File Type	File Date	Note

Comments

Date	Comment	Commenter
7/24/2009	RP is damming the creek at a culvert which is about ½ mile from the Des Moines River and will have a local contractor pump it out. . They have sandbagged the mouth of the creek at the river. They will pump it out and treat the water at Cargill-Eddyville's wastewater treatment facility. They will then flush and capture the entire stream.	DNRHSIADMIN

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

Ajinomoto Health and Nutrition North America, Inc - AHI - 310423788

1116 Highway 137 Eddyville, IA 52553-5001

Monroe 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