Spill - Template

Gelita Usa Sioux City - 310396197

2445 PORT NEAL RD. TO MISSOURI RIVER Sergeant Bluff, IA 51054

Woodbury County

FO 3

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Spill Number:

122301-KAL-1950

Spill Location:

42.349940, -96.354070

Spill County:

Woodbury

FO 3

Incident Report

Received:

Received By:

Discovered:

Assigned To:

Reported By:

Anonymous

DNR Observation

Individual

Company:

Name:

Title:

Phone:

Email:

Incident Information:

Sec:
Tier:
Range:
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
ROB MAYBERRY	General Permit #1 - Industrial Activity	Public Contact
GELITA NORTH AMERICA, INC.	General Permit #1 - Industrial Activity	Owner
SANDY WISECUP	General Permit #1 - Industrial Activity	Public Contact
ROB MAYBERRY	General Permit #1 - Industrial Activity	Public Contact
GELITA USA SIOUX CITY	Water Use	Permittee
GELITA USA Sioux City	Water Use	Legally Responsible Entity
GELITA USA SIOUX CITY	Water Use	Permittee
GELITA USA Sioux City	Water Use	Legally Responsible Entity
KNID & KNOX GELATINE, INC.	Major Industrial	Owner
GELITA NORTH AMERICA	Major Industrial	Owner
	Major Industrial	Mailing Contact
	Major Industrial	Mailing Contact
	Major Industrial	Mailing 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	Employees neutralized spill with soda ash and will flush the material to the storm water retention basin on site.	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

Gelita Usa Sioux City - 310396197

2445 PORT NEAL RD. TO MISSOURI RIVER Sergeant Bluff, IA 51054

Woodbury County

FO 3

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Facility Note

Incident Report

Responsible Party

Material Information

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Public Water Suppliers

Compliance Tracking

Possible Facility

Public Water Supply: Surface Water