Spill - Template

Aj Lackore Farms Inc - 310745129

15513 380th St Leland, IA 50453

Winnebago County

FO 2

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Spill Number:

042301-DJO-1635

Spill Location:

43.321435, -93.688181

Spill County:

Winnebago

FO 2

Incident Report

Received:

Received By:

Discovered:

Assigned To:

Reported By:

Anonymous

DNR Observation

Individual

Company:

Name:

Title:

Phone:

Email:

Incident Information:

Sec: 9
Tier: 98
Range: 24 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
	Adam Lackore	Confinement w/ MMP	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
042301-DJO-1635_01.pdf	Memo/ROI (public)	04/23/2001	Records pertaining to manure spill from 4-23-01
042301-DJO-1635_02.pdf	Memo/ROI (public)	04/23/2001	Records pertaining to manure spill from 4-23-01

File Name	File Type	File Date	Note

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

Aj Lackore Farms Inc - 310745129

15513 380th St Leland, IA 50453

Winnebago County

FO 2

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Incident Report

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Material Information

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Possible Facility

Public Water Supply: Surface Water