Spill - Template

Lone Pine L.l.c. - 310686945

23150 40th Street Fairbank, IA 50629

Fayette County

FO 1

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Spill Number:

100301-RPM-1030

Spill Location:

42.686000, -92.045620

Spill County:

Fayette

FO 1

Incident Report

Received:

Received By:

Discovered:

Assigned To:

Reported By:

Anonymous

DNR Observation

Individual

Company:

Name:

Title:

Phone:

Email:

Incident Information:

Sec: 17
Tier: 91
Range: 10
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
Lone Pine, LLC	Confinement w/ MMP	Owner
Brad Knudson	Confinement w/ MMP	Public Contact
Pinnacle Brian Ritland	Confinement w/ MMP	Public Contact
Josh Crouch	Confinement w/ MMP	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	The pumping was immediately stopped and the coupling reconnected. Liquids pooled in a ditch and absorbed into the ground. Responsible party was directed to remove residual solids and contaminated soils and land apply at proper 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

Lone Pine L.l.c. - 310686945

23150 40th Street Fairbank, IA 50629

Fayette County

FO 1

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Material Information

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Possible Facility

Public Water Supply: Surface Water