Spill - Template

George A. Hormel & Company - 310639888

209 N Godfrey Lane Knoxville, IA 50138

Marion County

FO 5

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Spill Number:

050807-CEC-0751

Spill Location:

41.316950, -93.062260

Spill County:

Marion

FO 5

Incident Report

Received:

Received By:

Discovered:

Assigned To:

Reported By:

Anonymous

DNR Observation

Individual

Company:

Name:

Title:

Phone:

Email:

Incident Information:

Sec: 9
Tier: 75
Range: 19 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
HORMEL FOODS CORPORATION	General Permit #1 - Industrial Activity	Owner
ROBERT GRAY	General Permit #1 - Industrial Activity	Public Contact
LOGAN HOTEK	General Permit #1 - Industrial Activity	Public Contact
GEORGE A. HORMEL & COMPANY	NPDES Industrial Contributor	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
7/24/2009	The building was evactuated and vented. Some of the ammonia was knocked down with water and entered into the waste water system of Knoxville. The city's waste water system has been notified. Matt will be in contact with total number of lbs lost.	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

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George A. Hormel & Company - 310639888

209 N Godfrey Lane Knoxville, IA 50138

Marion County

FO 5

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