NC0020117_Facility Notification_20011214

FACILITY NOTIFICATION REPORT FORM
Date Notification Received:
Facility's Name & County:
Facility NPDES Permit No.:
Person Making Notificat & L& Phone N
Notification Taken By:
Type of Unit Out of Operation:
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Permit Limit Violations:
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Type y No �ific/ ion: D _ �< <'��1+�. z . / . _4 ..._
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Date of Field Visit:
Samples Taken:
Yes:
No.
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Other Sections Involved:
CC: Belinda Henson/Inspection Files
Don Register
Dale Lopez/Tx Files
Kitty Kramer/DMR files
Paul Rawls