ILLICIT DISCHARGE HOTLINE INCIDENT TRACKING SHEET
Dil aki S Qvecharpe Oetectu AS fi ela eii ; haa = eh hela, er ce ete
Incident ID:
49
Responder Information
Call taken by: Call date:
; Precipitation (inches) in past 24-48
Call time: hrs:
Reporter Information
Incident time: Incident date:
Caller contact information (optional):
Incident Location (complete one or more below)
Latitude and longitude:
Or other coordinate system
Stream address or outfall #:
Closest street address:
Nearby landmark:
(Land not adjacent to stream) drain pond, wetland, ec.)
Narrative description of location:
Primary Location Description Secondary Location Description:
|_| Stream corridor
(in or adjacent to stream) [J Outfall ©) In-stream flow (J Along banks
[Upland area Near storm |_| Near other water source (storm water
Upland Problem Indicator Description
['] Dumping Oil/solvents/chemicals [1] Sewage
(} Wash water, suds, etc, (-] Other:
Stream Corridor Problem Indicator Description
= Ll cL Petroleum
Lj None [| Sewage Rancid/Sour (gas)
Odor |_| Sulfide
(rotten eggs); | [| Other: Describe in “Narrative” section
natural gas
(C) "Normal" | [-} Oil sheen (-] Cloudy () Suds
Appearance
{-) Other: Describe in “Narrative” section
Floatables {| None: sa ewes (toilet paper, CAlgae [] Dead fish
{_) Other: Describe in “Narrative” section
Narrative description of problem indicators:
Suspected Violator (name, personal or vehicle description, license plate #, address, etc.):
A-8
Hic it Discharge Detection and Eimination Plan
49
