Report Number: 20130259 is this a Drill? NO Report Taken By: SBAILEY Date: Time: 1506 Agency(s) to be Notified: TCEQ Reporting Party Information; Incident Date incident Time 01/22/201 3 0800 Reported By's Name Reporting Party Affiliation Contact Number Olhfif Phone NUNDBFISI RICHARD BRYAN TEXAS CHRISTIAN UNIVERSITY (817) 257-7955 (817) 257-6094 Materialisi Discharged or Spilledz Mat9liaI(s) CASIUN Number Amt Spliled Unit 22000.00 0.00 0.00 0.00 0.00 OTHER-SEWAGE DISCHARGE Discharge or Spill Location: NON COASTAL: County: Origin: 0 Land Re|ease 0n|y? Tarrant Fixed Non Facility Threatens or Entered Water 0 COASTAL: Threatens or Entered Water Receiving Water: DRAINAGE DITCH LEADS TO Amount In Water: 0.00 Units: unk 0 Air Release: no impact to water Incident Lotion I Drieiind 3500 BELLAIRE DRIVE NORTH, FORT WORTH, TX 75129 '-9359 RRC Lease Name: NIA RRC Field Name: NIA RRC Land Owner: Description of incident. Cause. Impact. and Response: AMOUNT LISTED ESTIMATED. THIS HAS BEEN GOING ON SINCE JULY 15, 2012, AND DISCOVERED YESTERDAY. CAUSE IS DURING RENOVATION TO A LOCKER ROOM THE SEWER LINE WASIACCIDENTALLY CONNECTED TO A STORM DRAIN. IMPACT IS WATER. RESPONSE IS THE LOCKER ROOM WAS IMMEDIATELY SHUT DOWN. THE DRAIN LINE IS CURRENTLY BEING RECONNECTED TO THE PROPER LINE. THE DITCH AND STORM DRAIN HAVE A CONSTANT FLOW OF WATER IN THEM. THE DISCHARGE POINT HAS BEEN INSPECTED WITH NO VISIBLE SIGN OF SEWAGE, ONLY WATER. QUANTITIES ARE PERIODIC, ONLY DURING USE OF THE LOCKER ROOM. Others Reportina Partv Notified: NRC Numbefi Agency Who Where Date Time NIA 0000 0000 0000 *Par_ty Responsible for Discharge I Spill: Film or Municipality: TEXAS CHRISTIAN UNIVERSITY - Street or P.0. Box: TCU BOX 297800 ctty: FORT WORTH State: TX Zip Code: 75129-0000 Contact Person: RICHARD BRYAN phone; (317) 257-7955 Emerctencv Hotline Phone Notifications: Agency who Where Date Time TCEQ WATKINS REG 04 01/23/2013 1520 0000 0000 Comments for late notifition ONLY: