NC0026352_Facility Notification_20000612

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FACILITY NOTIFICATION REPORT FORM •
Date Notification Received:.. (0- I', -0 u
Facility's Name & County: I o w n o Bla ate n 10 o r'r
Facility NPDES Permit No.: Ale, (Th a, 65 3 a
Person Making Notification & Phone No.:. C .1;p1,4) e < f q r Q10 sP (0 3 - 3 96, 7
Type of Unit Out of Operation:
Permit Limit Violations: A)o
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Type of Notificcjation: lQ ✓ ; �.C' (: ► S u notf re Oar5
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Date of Field Visit:
Notification Taken By:
Samples Taken:
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Yes:.
Field Office Actions and/or"Recommendations:
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No:
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Other Sections Involved:
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