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Appendix F <br /> Hazardous Waste Contingency Plan <br /> Discharge Notification Form <br /> Part A:Discharge Information <br /> General information when reporting a release to outside authorities: <br /> • Store Name,Address, and Telephone <br /> • Owner/Operator(The Home Depot U.S.A., Inc.) <br /> • Primary Contact(General Manager or Designee) <br /> Material released: Discharge Date and Time: <br /> Quantity released: Discovery Date and Time: <br /> Quantity released to a water body: Discharge Duration: <br /> Location/Source: <br /> Actions taken to stop, remove, and mitigate impacts of the discharge: <br /> Affected media: <br /> ❑air ❑sanitary sewer <br /> ❑water ❑secondary containment area <br /> ❑soil ❑other: <br /> Notification person: Telephone contact: <br /> Business: <br /> 24-hr: <br /> Nature of discharges,environmental/health effects, and damages: <br /> Injuries,fatalities, or evacuation required? <br /> Estimated quantity and disposition of recovered material that resulted from the incident: <br />