NC0028916_Facility Notification Form_20011101

FACILITY NOTIFICATION REPORT FORM
Date Notification Received. /1- / -- 61
Facility's Name & County: •
Facility NPDES Permit No.: i'C,UD -&( 4
Person Making Notification & Phone No:: s
Notification Taken By: (.: -,( I<-,c„<--.
7'CS * 4-.c. 44 = s /
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`Permit Limit Violations:
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Date of Field Visit:ScL c£z., � G-y
Samples Taken: A/k- Yes: No:
Field Office Actions and/or Recommendations:
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Other Sections Involved:
CC: Belinda Henson/Inspection Files
Don Register
Dale Lopez/Tx Files .1 �'
Kitty Kramer/DMR files
Paul Rawls