Spill - Template

Top Of Iowa Co-op - 311431242

101 North Park Lake Mills, IA

Winnebago County

FO 2

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Spill Number:

042103-AHB-1027

Spill Location:

43.419890, -93.537730

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: 3
Tier: 99
Range: 23
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

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	Employees placed soil berm to stop flow of fertilizer, pumped pooled liquid, and plan to over excavate contaminated soil. Soil will be placed I temporary storage until land applied to crop land at recommended fertilizer applications rates.	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

Top Of Iowa Co-op - 311431242

101 North Park Lake Mills, IA

Winnebago County

FO 2

Edit Facility Location

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Facility Note

Incident Report

Responsible Party

Material Information

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Public Water Suppliers

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Possible Facility

Public Water Supply: Surface Water