Document n9wepyMpXjoyp1Qk4RLx70Dv1
ENVIRONMENTAL UPSET REPORT
SUBJECT: FROM:
ur n/s G ____k,
__________________________
Please complete the following questionnaire and forward as soon as possible. [This report must be received by the Environmental Control Department within five (5) calendar days of the Incident.]
1. DATE OF INCIDENT:
J-X9-2S_______
2. SOURCE OF RELEASE: Uc <zm&iPPJnt,___ VjrK/~rf
3. TIME AND DURATION: xto 4. WEATHER CONDITIONS (Circle One): Clear
TOgPJn Partly Cloudy (cTou^) Rain
T
5. WIND SPEED AND DIRECTION (If a gas release):
mph
f>?rr TO UyE
6. HAZARDOUS MATERIAL RELEASED: tJc. r
nr ^
7. ESTIMATED QUANTITY RELEASED:
8. CAUSE OF RELEASE:
^Eu
_S kxsxjs.j <jL(?rOcits ,s ____ & V* y Jr.r;____ ___________________
jB..
9. IMMEDIATE ACTION TAKEN:
//v,~T s/fc/r__ */ U If__________
0 B.___ Kraft
'
XC___4$ 72f____________ Q__ //.U/
10. ACTION PLANS TO PREVENT REOCCURRENCE:
---- L--Z^.PlOf
4. .
77 0 a/__ g
V
_
f)P
e
11. NOTIFICATION MADE (Who, When): Vrrt/ nerp rzh, ft .Sotor y v/-nruo^>i~r
*
,/i/. rentitf , N'V.Ft
R^jorkeJl
<".'20,^ r>~ //z-9 _________ _____________________
Environmental File f l Qci ^
t<$^