Attachment_F_-_Reporting_Incidents_Discovery_of_Pollution.pdf

PDF 61 KB Posted

Attached to
Grease Traps and Lift Station Maintenance with Septic Tank Pump-Outs
Solicitation number
Y22-177
Issued by
Orange County, Orlando City, Florida

About this file

This document is a 24-Hour Notice of an Incident or Discovery of Pollution form from the Florida Department of Environmental Protection (DEP), specifically Attachment F of a reporting template for environmental incidents. The form is a standardized reporting document with multiple fields to capture critical details about potential pollution events, including incident name, discharge source, location, asset information, and incident description. The form includes sections for tracking the volume of substance released, recovered, and potentially discharged to surface water, along with a statement about public health risk.

The template appears designed to facilitate comprehensive and rapid reporting of environmental incidents, with designated spaces for identifying the specific facility, incident details, contact information, and quantitative measurements of the pollution event. While the form is blank in this instance, it provides a structured approach for organizations to document and report pollution-related incidents, ensuring transparency and enabling regulatory oversight of environmental occurrences. The form's design suggests it is part of Florida's regulatory framework for monitoring and managing potential environmental contamination events.

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Text version

https://flo ridadep.gov / d leer /oer /content/reportable-incident

Please Note:

Media Contact:

Facility Name:

24-Hour Notice Of an Incident Or Discovery Of Pollution

Name Of Incident:

Discharge Source(Facility/lnstallation Name):

Address Or Locatiorn

Asset Information:

Nearest Physical Address to Blockage/Malfunction:

State Watch Office Case# (N/a for Discharges< 1,000 gal):

Public Notice of Pollution Incident ID# (N/A for discharges <1,000 gal):

Identification of Parties Notified of Incident:

Date and Time of the Incident or Discover

Incident Description:

The Approximate gallons release and recovered are estimated to be as follows:_gallons released, _gal recovered, 0 gallons unrecovered, and O gallons discharged to surface water.

There is little or no potential risk to public health, safety, welfare.

Facility Workorder:

Permitted Facility Name and Location:

Facility Contact:

ATTACHMENT F

File details come from the government source that posted it. Updated .