Spill - Template

HEIDELBERG MATERIALS US INC. - 310200841

700 25th St NW Mason City, IA 50401

Cerro Gordo County

FO 2

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Spill Number:

050702-CDS-1710

Spill Location:

43.177040, -93.213130

Spill County:

Cerro Gordo

FO 2

Incident Report

Received:

Received By:

Discovered:

Assigned To:

Reported By:

Anonymous

DNR Observation

Individual

Company:

Name:

Title:

Phone:

Email:

Incident Information:

Sec: 33
Tier: 97
Range: 20 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
LEHIGH CEMENT COMPANY	General Permit #1 - Industrial Activity	Legal Operator
Kimberlie Bumgardner	General Permit #1 - Industrial Activity	Public Contact
KIMBERLIE BUMGARDNER	General Permit #1 - Industrial Activity	Public Contact
Perry Dargitz	FO	Owner/Operator
LEHIGH CEMENT COMPANY LLC	Minor Industrial	Owner
LEHIGH CEMENT COMPANY LLC	Minor Industrial	Owner
HEIDELBERG MATERIALS US CEMENT LLC	Minor Industrial	Owner
	Minor Industrial	Mailing Contact
	Minor Industrial	Mailing Contact
	Minor Industrial	Mailing Contact
LEHIGH CEMENT COMPANY LLC	Minor Industrial	Owner
HEIDELBERG MATERIALS US CEMENT LLC	Minor Industrial	Owner
	Minor Industrial	Mailing Contact
	Minor Industrial	Mailing Contact
	Minor Industrial	Mailing Contact
HEIDELBERG MATERIALS US INC.	UST	Owner
	UST	Public Contact
Heidelberg Materials	Water Use	Permittee
Heidelberg Materials US Cement LLC	Water Use	Owner
Heidelberg Materials	Water Use	Permittee
LEHIGH CEMENT CO LLC	Water Use	Owner
HEIDELBERG MATERIALS US CEMENT LLC	Non-Transient Non-Community	Owner
HEIDELBERG MATERIALS US CEMENT LLC	Non-Transient Non-Community	Public Contact
Heidelberg Materials CKD	Reuse (soil, wastes, exempt materials)	Legally Responsible Entity
Lehigh Cement Company - Mason City	Title V	Public Contact
Rachel	Title V	Public Contact
Rachel Glaza	Title V	Public Contact
Wendy Krause	Title V	Public Contact
Patrick Karamaga	Title V	Public Contact
Kimberlie Bumgardner	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
7/24/2009	Place booms around outlet, soak up oil with pads, properly dispose of booms/pads.	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

HEIDELBERG MATERIALS US INC. - 310200841

700 25th St NW Mason City, IA 50401

Cerro Gordo County

FO 2

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