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St:CTJUN I -at. ......~ ~ New York State Department of Environmental Conservation Division of Water Report of Non cOl1tJllian ce Event To: DEC Water Contact DEe Region: Report Type: _ 5 Day ~ermit Violation Order Violation _ Anticipated Noncompliance _ Bypass/Overflow -..- -.- ...- ...Ao"'....".-;..,.........= ~."'"'~.~ "-'''l<~ ""<l' SECTION 2 SPDES #: NY- 003S"~3 7 Facility: (h:d ~~.1~ p~ 51) Wl.OrP - Q,yctl RcJg Date of noncompliance: 'l 1 / ().s;- Loe.ation (OutfaIl, Treatment Unit, or Pump Station): t>U.} ~ 1 r Description ofnoncompliance(s) and cause(s): (nDIl-.ll/y QlJtl'o~f fin.,.) 0. h~aJt' P',..tn.+ Jelk I Nil' tD ~ eqvy t'o;\,.k> " Qnd ::r t I. Has event ceased? (Yes) (No) Ifso, when? Wa~ event due to plant upset? (Yes)~ SPDES limfts viOI2.ted~ (No) Start date, time of event: Y' / I IO(~(pM) End date, time of event: ~ 17C>/05", JI ::f'1CAM)(jjiJ Date, time oral notification made to DEe? 1 1 (AM) (PM) DEC Official contacted: Immediate corrective actions: Preventive (long term) corrective actions:~o(' ~I~ 6^ "1: +,: prohieM' ~__'-"P."'" .r-. ,-,_..._" > ~""",o;.~_"",~=_"".___ '-'r~ ..."'- ~-==" -=>.' ~_.."'._ ,.WI",,- ___._____ . _._ -~. .......,.,.,,- SECTION 3 Complete this section if event was a bypass: Bypass amount: Was prior DEe authorization received for this ~vent? (Yes) (No) DEC Official contacted: Date ofDEC approval: 1 Describe event in "Description of noncompliance and cause" area in Section Z. Detail the start ~nd end dates mnd times in Section Z uso. J:: SECTION 4 Facility Representative: fA. Vlfe(t..~ ( Phone#:(8"~)M .73/l.) ~... ~ """- ... TitleOJu.o{O/2Q(a:k>f Date:....a 1211 0.5 I Fax #: (~4~ ) ~. 73/).5 r Certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accord:mce 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 infonnation submitted is, to the best of my l'llowledge and belief, true, accurate, and complete. r am aware that there are significant penalties for submitting false information, including the possibility affine and imprisonment for knowing violations. x f/~t~ Signature of Principal Executive Officer or Authorized Agent