Field Office Compliance - Spill

United Suppliers Inc - 310808547

30473 260TH STREET Eldora, IA 50627

Hardin County

FO 2

Spill Number:

120709-AHB-1312

Spill Location:

42.330000, -93.110000

Spill County:

Hardin

FO 2

Incident Report

Received:

Received By:

Discovered:

Assigned To:

Reported By:

Anonymous

DNR Observation

Individual

Company:

Name:

Title:

Phone:

Email:

Incident Information:

Sec:
Tier:
Range: 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

Material Information


Material: Medium: Quantity: Units:
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
12/8/2009	Monitor process and report any problems.	ADAM BROUGHTON

Comment:

Public Water Suppliers

Name	Supply Type	PWS ID	Operator: Name / Phone Number	Contacted

Compliance Tracking

Action Type	Date	Completed Date	Comment	Delete

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Field Office Compliance - Spill

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United Suppliers Inc - 310808547

30473 260TH STREET Eldora, IA 50627

Hardin County

FO 2

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Incident Report

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Public Water Suppliers

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Possible Facility

Public Water Supply: Surface Water