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°p4u'IN SAN JOAQUIN COUNTY <br /> y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1 600 East Main Street Stockton • CA 95202-3029 <br /> (209)468-3420• Fax:(209)464-0138• Web:www.sigov.org/ehd <br /> 9��FOR� <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> A. EMERGENCY LEVEL ❑x 1 ❑ i1 ❑ III EHD LOG# - 3 <br /> B. SOURCE OF INFORMATION <br /> NAME: Garrett Backus PHONE: (209)468-2986 <br /> COMPANY: San Joaquin County Environmental Health Department CITY: Stockton <br /> ADDRESS: 600 E. Main Street <br /> DESIGNATED EMPLOYEE NAME: Garrett Backus PHONE: (209)468-2986 <br /> REPORTING AGENCY NAME: San Joaquin County Environmental Health Department <br /> ADDRESS: 600 E. Main Street, Stockton, CA 95202 <br /> C. LOCATION AND DATE OF DISCHARGE <br /> R <br /> ❑ Inco rated <br /> National Guard Maintenance, 8020 S Airport Way Cin. Stockton <br /> x Uninco❑ rporated <br /> CHARGE: May 7, 2012 <br /> DATE NOTIFIED: Monday, May 7, 2012 TIME: 1:30 pm <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> NAME OF BUSINESs: National Guard Maintenance <br /> CONTACT PERSON: Kirk Lance PHONE: (209)604-9792 <br /> PHYSICAL ADDRESS: National Guard, 8020 S Airport Way, Stockton, CA 95206 <br /> MAILINGADDRESS: National Guard, 8020 S Airport Way, Stockton, CA 95206 <br /> E. DESCRIPTION <br /> TYPE OF DISCHARGE: Spill of hydraulic oil from equipment. <br /> VOLUME: approximately 10 gallons <br /> CHEMICALS: hydraulic oil <br /> CIRCUMSTANCES: Emergency response Call and response. <br /> F. ACTION TAKEN <br /> Responsible party organized cleanup and disposal of oily absorbent waste. <br /> SITE DISPOSITION <br /> E <br /> her action. <br /> NOTIFICATION OF HAZ WASTE DISCHARGE Page 1 of 2 Revised 10/22/10 <br />