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II E '" c o :e i '" " o .~ 0. ~ 1 J I I j J J l I I ) J J I J i I I 1 I I I I i ) 1 J 1 I I I I I I I 1 1 I 1 I I I I I r f I f I I I I I I I i I I I f I I I I I I ~ ~ ~ R ~ IL ~ W ......""'" . SECTION J ~ ...... ~ New York State Department of Environmental Conservation Division of Water Report Q[ Noncompliance Event ~. . ,. I To: DEe Water Contact DEe Region: Report Type: _ 5 Day ./ Permit Violation _ Order Violation _Anticipated Noncompliance _Bypass/Overflow SECTION 2 SPDES#: NY.aD3S-(037 Facfllty: 0' / Date of noncompliance: \ I lOS-Location (Outfall, Treatment Unit, or Pump Station): ~ to II Desa;iptJqn ofnoncompllance(s) rd cause(S):zt"IYb~..fh)y q,lkroQ( .p{(l.V Db:>ile prm/ t leWJ' rJue +-0 heoVy (0..", k..11 I ShDC.u M.../ o"d + . . Has event ceased? (Y cs) (No) If SOt when? Start date, tlm.e of event: J II I of". ..lJ.. 00 War event due to plant upset? (Yes) ~ SPDES limits violated?~ (No) .~ (PM) End date, time of event: I I)) 105': II :59 (AM)~ Date, time oral notlflcatlon made to DEe? I I (AM) (PM) DEe Official contacted: Immediate corrective actions: Preventive (long term) correctIve actJons:~~\'''' () (\ :J:.+ ~ prrkl.e M . SECTION 3 ComoJete this section ifevent was a bvoass: Bypass amount Wu prior DEe authorization received for this c.vent? (Yes) (No) DEe Official contacted: Date ofDEC approval: I I Describe event in "DescriptIon of noncompliance and cause" area in Section 2. Detail the start and end dates and times in Section Z also. rr SECTION 4 FacilitY Representative: J"YL. P .We()\. pQ/ Pbone#:( y~Jtj_73Ib TItle> 'YiQ. PrC;:;ick.c-+ 0....2 ,246..5 Fax if: ( 81-s) ~ _ 73C.{ 1 Certify under penalty of law thallhis document and all attachments were prepared under my direction or supenrision in accordance with I system designed to assure that qualified personnel properly gather and evaluate the infonnation submitted. Based on my inquiry oflhe person or persons who manage the system, or those persons directly responsible for gathering the infonnation, the infonnation submitted is, to the best of my knowledge and belief. true,lccurate, and complete. 1 am aWllre that lhere are significant penalties for submitting false infonnation, inCluding ihe possibility of fine and imprisonment for knowing violations. x~/~ Signature of Principal Executive . . Officer or Authorized Agent