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Illicit Discharge Hotline Incident Tracking Shect <br /> Incident ID: 2a I _ e)0 i <br /> Responder Information <br /> Call taken by: J,.jsT j.%j Call date: 2_t v Z_L) <br /> Call time: Precipitation(inches)in past 24-48 hrs: <br /> Reporter Information <br /> Incident time: Incident date: <br /> Caller contact information(optional): 6Mtj A IJ`Z_ <br /> Jnr'a„ 1.7-1 e- <br /> Incident Location (complete one or more below) <br /> Latitude and longitude: <br /> Stream address or outfall#: <br /> Closest street address: <br /> Nearby landmark: S y'vLi- h l P_ Po IL-r(— e '/i T6 <br /> Primary Location Description Secondary Location Description: <br /> ❑ Stream corridor ElAlong banks <br /> In or adjacent to stream El Outfall ❑In-stream flow <br /> Upland area Near storm drain ❑Near other water source(storm water pond,wetland,etc.): <br /> (Land not adjacent to stream) <br /> Narrative description of location: <br /> Upland Problem Indicator Description <br /> ❑Dumping ❑Oil/solvents/chemicals ❑Sewage <br /> ❑ Wash water,suds,etc. ❑Other: <br /> Stream Corridor Problem Indicator Description <br /> None [-ISewage ElRancid/Sour ❑ Petroleum(gas) <br /> Odor <br /> ❑Sulfide(rotten eggs); ❑Other:Describe in"Narrative"section <br /> natural gas <br /> "Normal" ElOil sheen ElCloudy ❑Suds <br /> Appearance <br /> ❑Other: Describe in"Narrative"section <br /> None. ElSewage(toilet paper,etc) 1:1Algae ElDead fish <br /> Floatables <br /> ❑Other: Describe in"Narrative"section <br /> Narrative description of problem indicators: <br /> Nd&JE <br /> Suspected Violator(name,personal or vehicle description,license plate#,etc.): <br /> 4 A ILu AL_t-v M-2- <br /> -3 VZ- <br /> -23VZ-7 1gAjLvCY Ave <br /> C-9 <br />