Notification of an Incident or Discovery of Pollution(19)
3/20/2017 08:15:00 AM
Bartow, Fla. (March 19, 2017) — Although no longer required, the Board
of County Commissioners is providing you notification that aformal report
was sent, via email, to email@example.com.
A formal report is being sent, via
email, to firstname.lastname@example.org.
of reporting party: Polk County Fire Rescue
Installation Name: Polk County Board of County Commissioners
Installation Address: 330 W. Church Street
Installation Location: Bartow, FL 33830
Contact person for further information: Mianne Nelson (863) 232-6653
Permit Number (if facility/installation holds a permit): none
Date and time of the incident or discovery: Sunday, March 19,
2017 7:55 a.m.
Location of the incident or discovery: 4320 Bailey Road, Mulberry FL
Suspected source and cause of incident or discovery: Insert
Type of pollution, including substance or contaminant name(s): fuel
Amount of pollution, including substance or contaminant name(s): About
Medium (e.g. land, water, air) affected by pollution: water, land
Potentially affected areas beyond installation property boundary: none
Potential risk to the public health, safety, or welfare: none
Identification of other parties notified of incident and time notification
occurred: DEP via email, March 19, 2017 12:00 p.m.
information that may be helpful: About 5 gallons of fuel spilled
following a motor vehicle crash. Oil on top of water chemically treated and
absorbent pads were used on land.