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SECTION I
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New York State Department of Environmental Conservation
Division of Water
Report of Noncompliance Event
To: DEC Water Contact
DEe Region:
Report Type: _ 5 Day ~rmit Violation
Order Violation _ Anticipated Noncompliance _ BypasslOve1flow
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SECTION 2
SPDES#:NY.(i)3~c,3 7 Facility: (h.d fb:f\~ PK-.c:,O iAlt..VI.a- a,'yCt1 R'-f-
Date of noncompliance: "7 1 IC({'" Location (Outfall, Treatment Unit, or Pump Station): DJt.,~ II
Description of noncompliance(s) and eause(s): I .Ivi' it) '<' /\ t~ II C.n()
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Has event ceased? (Yes) (No) If so, when? Was event due to plant upset? (Yes) ~ SPDES limits Violated?G;l (No)
St~rt d2te, timF> of event: '/ / I / 0.'5'. .I;). :00 e (PM) Enr' date, time of event: _7 1 '] l D). 11 :.)1 (A':.(fjJ
Date, time oral notification made to DEe? 1 1 (AM) (PM) DEC Official contacted:
Immediate corrective actions:
Preventive (long term) corrective actions: Wo r~ V'9 ()'(\ I + ~ (>r:-r)h Ip IJI\
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SECTION 3
Complete th is section if event was a bvoll.Ss:-
Bypass amount:
w~ prior D EC authorization received for this event? (Yes) (No)
DEC Official contacted:
Date ofDEC approval:
1
I
Describe event in "Description of noncompliance and cause" area in Section Z. Detail the start !.ud end d~tes Qod times in Section Z also.
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SECTION 4
facilitY Representative~hfl P. &+10
Phone #: ('i~5 ) 1u3 .7-3 10
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TitIe:..:5pV. ~1tr Date: Y 12-1/ ,s
Fax #: /ft/s )~ .73 Di
I Certify under penalty of law thallhis document and all attachments were
prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gather and evaluate the information
Submitted, Based on my inquiry oflhe person or persons who manage the system,
or those persons directly responsible for gathering the information, the information
Submitted is, to the best of my knowledge and belief. true, accurate, and complete.
I am aware that there are significant penalties for submitting false information,
including the possibility of fine and imprisonment for knowing violations,
,/'
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