Spill - Template

Kraft Foods, Inc - Mason City - 12th St - 311308064

21226 265TH ST. Mason City, IA 50401

Cerro Gordo County

FO 2

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Spill Number:

081621-KB1-0950

Spill Location:

43.160000, -93.220000

Spill County:

Cerro Gordo

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:

Name	Program	Type
Kraft Foods, Inc.	Land Application	Legally Responsible Entity
KRAFT FOODS, INC.	General Permit #1 - Industrial Activity	Legal Operator
KRAFT HEINZ COMPANY	General Permit #1 - Industrial Activity	Owner
DAVE HAAG	General Permit #1 - Industrial Activity	Public Contact
JOE SHULTZ	General Permit #1 - Industrial Activity	Public Contact
KRAFT HEINZ CO	General Permit #1 - Industrial Activity	Owner
CLINTON PAYNE	General Permit #1 - Industrial Activity	Public Contact
DAVE HAAG	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

Document Name	Type	File Date	Note
10-25-2021\081621-KB1-0950.pdf	Report		30 day report
07-29-2022\Spill 081621-KB1-0950 Safety Data Sheet.pdf	Report		Safety Data Sheet

File Name	File Type	File Date	Note

Comments

Date	Comment	Commenter
8/23/2021	Per Kayla Beck - no action/follow up information	JENNIFER LOATS

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

Kraft Foods, Inc - Mason City - 12th St - 311308064

21226 265TH ST. Mason City, IA 50401

Cerro Gordo 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

Compliance Tracking

Possible Facility

Public Water Supply: Surface Water