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i <br /> I i SPILL REPORT <br /> 1 <br /> DATE: TIME: <br /> 1 <br /> 1. Name of Individual Reporting Spill: <br /> � 2. Location of Spill: <br /> I 3. Type of Material Spilled: _ I <br /> 4. Estimated Quantiry Spilled: <br /> I5. Description of Spill (Odor, Color, Dimensions, e[c.): <br /> 6. Source of Spill: <br /> I7. Did Malerial Reach a Sewer? Yes/No Sewer Type: Industrial Sanitary Storm <br /> 8. Did Material Soak into Soil? Yes/No Estimateti quantity: <br /> � 9. Did Material Leave Properly? Yes/No Estimated Quanliry: <br /> I10 Property(ies)/Stream(s) Impaded? <br /> 11. Adion Taken (Description of Initial ContainmenURecover Procedures): <br /> � <br /> I <br /> � (con:inued on back) <br /> ( 12. Weather Conditions at Site: __ <br /> I <br /> 13. Party Responsible for Spill: <br /> I14. Name of Individual Preparing Report: <br /> IGTHER INFOFbSATION/C0�1M17ENTS: <br /> l <br /> � Stormwater Site Plan Q Q � O <br /> Fvcrett Communily College <br /> TopPcr Parking Lo[ ZZ � <br /> 208221.10 � <br /> � 25 <br />