Discharge Notification

REPORT THE FOLLOWING INFORMATION:

1. Name, address, and telephone number of person reporting;
2. Name, address, and telephone number of person responsible for the discharge or release, if known;
3. Date and time of the discharge or release;
4. Type or name of substance discharged or released;
5. Estimated amount of the discharge or release;
6. Location or address of discharge or release;
7. Source and cause of the discharge or release;
8. Size and characteristics of area affected by the discharge or release;
9. Containment and cleanup actions taken to date; and
10. Other persons or agencies contacted.