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Ff,�s:Cal ERA (State Warning renter) 9168458910 0508/2009 00:03 #385 P.001/002 <br /> California Emergency Managemen y <br /> Hazardous Materials Spill D <br /> DATE: 05/07/2009 RECEIVED BY: CONTROL#: <br /> TATE: 2354 Cal EMA- Ronald Demayo Cal EMA- U9-3. <br /> OSPR- <br /> INRC- <br /> La- <br /> PERSON NOTIFYING Cal EMA: <br /> I. NAME: 2. AGENCY: 3. PHONE#: 4.Est: S.PAG/CELL: a <br /> Bob NeaRtan Stockton Fire Department 209-937-5030 <br /> 1-b. PERSON REPORTING SPILL(If different from above): <br /> 1. NAME: 2. AGENCY: 3. PHONE#: 4. Est: 5.PAG/CELL: <br /> 2. SUBSTANCE TYPE: <br /> 2.a.SUBSTANCE: b.QTY:r_c AMMW Meesare C TYPE: d.OTHER: <br /> 1. Water/Tire Waste = 20,000 Galls) OTHER Water/Tire <br /> _ <br /> Waste <br /> 2. <br /> 3. <br /> e. Caller states fire suppression at a tire waste facility resulted in the release of substance. The fire is <br /> DESCRIPTION out and San Joaquin County Environmental Health will oversee clean up operations by the agency <br /> that will be handling remediation efforts. <br /> E CONTAINED: g.WATER INVOLVED: h.WATERWAY: i.DRINKI:NG WATER AIPACTED <br /> yes No <br /> j.KNOWN None <br /> ATPACT <br /> 3. a.INCIDENT LOCATION: 4447 South Airport <br /> b.CrfY: c.COUNTY: it.7.IP: <br /> Stockton San Joaquin County <br /> 4.INCIDENT DESCRIPTION: <br /> a.DATE: b. TATE (Miimy): c.SrrE: d. CAUSE <br /> 05%07!2009 2300 Merchant/Business Other <br /> Description for Other: Fire <br /> Suppression. <br /> e. :LNJURDE S'# 1. FA7:4,I S#: g.EVACS#: h.C:L:EANUP BY: <br /> 0 0 0 Unknown <br /> Same as#1."PERSON NOTIFYING Cal....E <br /> .................................................................. ....... <br /> S. SUSPECTED RESPONSIBLE PARTY: <br /> o.NAME: b. AGENCY: c.PHONE#: d.EXT.: <br /> RCL Manufacturing 209-662-1033 <br /> e.MAI' E CITY: g.STATE: h.23P: <br /> ADDRESS: <br /> 4447 South Airport Stockton CA <br /> 6. NOTIFICATION INFORMATION: <br /> Is.ON SCENE: b.OTHER ON SCENE: c.OTHER NOTIFIED: <br /> Fin Dept. <br /> San Joaquin County Environmental <br /> Health and OES,Air Pollution <br /> Control <br /> d.ADMIN.AGENCY: sen Ioaquin cwnty e.SEC.AGENCY: <br /> Enavmy Services <br /> f. ADDITIONAL COUNTY: g.ADMIN.AGENCY: <br /> It.NOTIFICATION LIST: <br /> DOG UNt: RWQCB Unit: 513 <br />