Spill - Template

Love's Travel Stop #361 - 310659951

4400 S 22ND AVE E Newton, IA 50208

Jasper County

FO 5

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Spill Number:

011114-WCG-1207

Spill Location:

41.680000, -93.000000

Spill County:

Jasper

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:

Select	Name	Program	Type
	LOVE'S TRAVEL STOPS & COUNTRY STORES	UST	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

Document Name	Type	File Date	Note
01-23-2014\Love's - Newton (011114-WCG-1207).pdf	Report		spill report

File Name	File Type	File Date	Note

Comments

Date	Comment	Commenter
1/13/2014	The released fuel was contained to the concrete and did not enter the storm sewer. Seneca Waste Solutions was enroute to conduct the cleanup. Later in the day Love's called and reported that the spill had been cleaned up. 1/13/14 - I called Seneca and confirmed the cleanup was complete.	BILL GROSS

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

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Love's Travel Stop #361 - 310659951

4400 S 22ND AVE E Newton, IA 50208

Jasper County

FO 5

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Public Water Supply: Surface Water