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SAN JOAQUIN COUNTY <br />.� �,.✓IRONMENTAL HEALTH DEPARTMb, I" <br />..� - 600 E Main Street Stockton • CA 95202 <br />(209) 468-3420 • Fax. (209) 464-0138 • Web: www.sjqov.org/ehd <br />�FpR <br />EMERGENCY RESPONSE RECORD <br />DATE: <br />12-30-10 <br />SHORT TERM#: <br />C000*,�Lva <br />PREMISE <br />ADDRESS: <br />3932 Newton Rd <br />CITY: <br />Stockton, CA <br />DBA: <br />Conti Materials Svc Corp <br />PREMISE <br />OWNER: <br />Mike Conti <br />PHONE: <br />F(209)467-0626 ext. 7 <br />OWNER'S ADDRESS: <br />3932 Newton Rd <br />CITY: <br />Stockton, CA 95205 <br />FACILITY CONTACT: <br />Mike Conti <br />PHONE: <br />(209) 467-0626 ext. 7 <br />x LIQUID <br />GRANULE <br />RESPONSIBLE PARTY (RP)General <br />DBA: <br />Petroleum <br />RP <br />NAME: <br />Brian Biancavilla <br />PHONE: <br />(602) 690-2142 <br />RP ADDRESS: <br />19501 S. Santa Fe Ave. <br />CITY: <br />Rancho Dominguez, CA 90221 <br />RP CONTACT: <br />Brian Biancavilla <br />PHONE: <br />(602) 690-2142 <br />NATURE OF COMPLAINT (explosion, spill, leak, fire, or abandoned/dumped material) <br />During fueling of a customer's tank, incorrect calculations caused an overflow of diesel fuel. <br />TIME RECEIVED: <br />9:25am <br />TIME OF ARRIVAL: <br />10:30 am <br />TIME OF DEPARTURE: <br />11:30 am <br />PERSONS AT SCENE <br />NAME AGENCY PHONE TOA TOD <br />Mike Conti Conti Material Service LLC 209 467-0626 ext7 <br />Aris Caca it SJC EHD 209 468-3453 10:30 11:30 <br />I NO <br />IDENTIFICATION OF MATERIAL (CHEMICAL INVOLVED) <br />SUBSTANCE FORM <br />I SOLID <br />POWDER <br />GAS I <br />x LIQUID <br />GRANULE <br />REFERRALS TO: <br />ADDRESS PHONE <br />DATE MAILED: <br />DATE COMPLETED.... PROP 65: <br />12-30-10 <br />UAR: <br />PERSONS EXPOSED and/or INJURED <br />NAME <br />ADDRESS PHONE <br />"PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD" COMPLETED? <br />YES J <br />I NO <br />E. R. BINDER COPIES: <br />x SHORT-TERM ON TOP x NARRATIVE ANALYTICAL DATA T7PROP 65 / LAIR <br />EXPOSURE RECORD MANIFEST CLEANUP REPORT OTHER AGENCY REPORTS <br />REFERRALS x MAP FILE CREATED <br />ER RECORD ELECTRONIC VERSION Page i of� 01/16/09 <br />