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New York State Department of Environmental Conservation
Division of Water
Renort of Non C011tlJlian ce Event
- ~ -
To: DEC Water Contact
DEe Region:
Report Type: _ 5 Day ~ermit Violation
Order Violation _ Anticipated Noncompliance _ Bypass/Overflow
. =""~........o.;""" "'-=".,;;""'"~=-~._ .o=.~_
.....-
--
SECTION 2
SPDES #: NY- 00 a I {.,O i Facility: ~/€~+ Wood f1'\CI1U" 1..4 JW'if'i
- .~
Date of noncompliance: i / 10:> Location (Outfall, Treatment Unit, or Pump Station):OJ t:\O..l!
D "ription ofnoncompliance(s) and eause(s :SVS (: I
. . ~c:.W . ". eltel' I . ,
War event due to plant upset? (Yes)
SPDES limits violated? (;;) (No)
/ (AM) (PM)
Has event ceased? (Yes) (No) If so, when?
Start date, time of event: '3 IIDS:...
(AM) (PM) End date, time of event: /
Date, time oral notification made to DEe?
/ /
(AM) (PM) DEe Official contacted:
Immediate corrective actions:
Preventive (long term) corrective actions:
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SECTION 3
Complete this section if event was a bV02SS:
Bypass amount
Was prior DEC authorization received for this event? (Yes) (No)
DEC Official contacted:
Date afDEC approval:
/
/
Descrihe event in "Description of noncompliance and cause" m.rea in Section 2. Dewl the start 2nd end dates mnd times in Section Z ~lso.
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SECTION 4
FacilitY Representative: /Yt . P. Ve tH W
I
Phone#: (o~6 ~ 7-31D
TitIeCL~[ {)D.Q{Q{QLD2.te: 1/271 t>..f
,
FE.l'.#: (8~.jS #-03 .73 oj
I Certify under penalty of law thaI Ihis document and allattachrnents were
prepaTed under my direction or supervision in accord:mce with a system designed
to assure Ihat 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, 10 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.
~,!!f::ldl!~
Officer or Authorized Agent