290090_NOV-2020-DV-0468 Event Report_20200811

DWRIncident Report
Division of Water Resources Report Number: 202002829
Incident Type :
Complaint
On -Site Contact
Category
APS - Animal
First/Mid/Last Name : Terry Khan
Incident Started ;
08/11/2020
Company Name
Country :
Davidson
Phone : [phone]
City:
High Point
Pager/Mobile Phone
Farm # :
290090
Responsible Party:
Owner:
Reported By
Permit:
AWD290090
First/Mid/Last Name
Facility:
Halal Processing
Company Name
First Name :
William
Address
Middle Name:
Charles
Last Name :
Swaim
City/State/Zip
Address :
338 Eaton Dr
Phone
Page/Mobile Phone: /
City/State/Zip :
High Point NC 27265
Phone:
Material Category:
Estimated City: UOM:
Chemical Name Reportable Qty.lbs. Reportable Qty.kgs.
DD:MM:SS Decimal
Position Method
Latitude :
Position Accuracy:
Longtitude :
Position Datum
Location of Incident
: 338 Eaton Drive
Address :
338 Eaton Dr
City/State/Zip :
High Point
NC 27265
Report Created 10/23/20 2:26 pm Page 1

Cause/Observation :
DWR responding to referral from NCDA for meat processor with
animal waste concerns to surface waters
Action Taken :
Incident Questions :
Did the Material reach the surface Water? Unknown
Surface Water Name ?
Did the Spill result in a Fish Kill? Unknown
If the Spill was from a storage tank indicate type :
Containment? Unknown
Cleanup Complete? Unknown
Water Supply Wells within 1500ft
Unknown
Directions :
Comments :
Conveyance:
Estimated Number of fish?
(Above Ground or Under Ground)
Groundwater Impacted :Unknown
Report Created 10/23/20 2:26 pm Page 2

Event Type
Event Date Due Date
Incident closed
Requested Additional Information
Report Received
Referred to Regional Office - Primary Contact
Report Entered
2020/10/23
1:07:00
Inspection or Site Visit Conducted
2020/10/22
12:30:00
Violation Determined (Remove confidentiality)
2020/09/09
3:00:00
Lab Results Received
2020/09/09
3:00:00
Incident Start
2020/08/11
8:00:00
Standard Agencies Notified
Agency Name Phone
First Name
M.I. Last Name
Other Agencies Notified :
Agency Name Phone First Name M.I. Last Name
DWQ Information :
Report Taken By: Report Entered By:
Rebecca D Chandler
Phone:
Date/Time:
Referred Via:
Did DWQ request an additional written report?
If yes, What additional information is needed?
2020/10/23 01:07:OOPM
Comment
Contact Date
Contact Date
Regional Contact:
Report Created 10/23/20 2:26 pm Page 3