NC0026921_Facility Notification Report Form_20020111

FACIT,TTY NOTIFICATION REPORT FORM
Date Notification Received: / `// 0
Facility's Naive & County: f P . —
Facility NPDES Permit No.; W
Person Making Notification & Phone No.: r j.
Notification Taken By. ./N. lG /,_ (> 1;./t_..7
/
Type of Unit Out of Operation:
,.l,
Permit Lith.it Violations:
Type of Notification:
t�
•
Date of. Field Visit:
Samples Taken:
Yes: No:
Field Office Actions and/or Recommendations:
4.7
e
/1/L: // ,.J / m %%C ;
Other Sections Involved:
CC: Belinda Henson/Inspection Files
Don Register
Dale Lopez/Tx Files
Ditty Krramer/DIVIR files .
Paul Rawls