Spill - Template

Lennox Industries Inc - Marshalltown - 310623986

200 S. 12TH AVE. Marshalltown, IA 50158

Marshall County

FO 5

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Spill Number:

100704-AHB-1221

Spill Location:

42.047400, -92.892640

Spill County:

Marshall

FO 5

Incident Report

Received:

Received By:

Discovered:

Assigned To:

Reported By:

Anonymous

DNR Observation

Individual

Company:

Name:

Title:

Phone:

Email:

Incident Information:

Sec: 36
Tier: 84
Range: 18
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
LENNOX INDUSTRIES, INC.	General Permit #1 - Industrial Activity	Owner
DOUG BAGGETT	General Permit #1 - Industrial Activity	Public Contact
LENNOX MANUFACTURING INC.	General Permit #1 - Industrial Activity	Legal Operator
JOHN SCHULER	General Permit #1 - Industrial Activity	Public Contact
JOHN SCHULER	General Permit #1 - Industrial Activity	Public Contact
JOHN SCHULER	General Permit #1 - Industrial Activity	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	Shut off flow to line. Called in locates and excavate line check soil and repair line.	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

Lennox Industries Inc - Marshalltown - 310623986

200 S. 12TH AVE. Marshalltown, IA 50158

Marshall County

FO 5

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Public Water Supply: Surface Water