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t <br /> EMERGENCY RELEASE FOLLOW-UP NOTICE <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> BUSINESS NAME FACILITY EMERGENCY CONTACT&PHONE NUMBER <br /> J.R. Simplot Company Tim Van Domelen ( 209)858-2511 <br /> B TIME <br /> INCIDENT MO DAY YR SJC EHD :Cal-EMA <br /> DATE 715/10 NOTIFIED 09:57-7/5/10(use 24 hr time) NTROL NO. 10-4058 <br /> aINCIDENT ADDRESS LOCATION CITY/COMMUNITY COUNTY ZIP <br /> 16777 Howland Road Lathrop [San Joaquin 95330 <br /> CHEMICAL OR TRADE NAME (print or type) AS Number 7446-11-9 <br /> Sulfur TriOxide till <br /> CHECK IF CHEMICAL 1S LISTED IN CHECK IF RELEASE REQUIRES NOTIFICATION <br /> D 40 CFR 355,APPENDIX A ® H UNDER 42 U.S.C.SECTION 9603 a <br /> PHYSICAL STATE CONTAINED PHYSICAL STATE RELEASED 11 QUANTITY RELEASED <br /> [:] SOLID ❑LIQUID ®GAS A ❑ SOLID ❑ LIQUID ®GAS 4,207 lbs <br /> ENVIRONMENTAL CONTAMINATION TIME OF RELEASE DURATION OF RELEASE <br /> ®AIR ❑WATER❑GROUND❑OTHER 0900 0 DAYS 0 HOURS 30 MINUTES <br /> ACTIONS TAKEN <br /> On 7/5/2010 at approx 0900 a water system failure in the sulfuric acid plant caused the release of 4207 lbs of S03.The release <br /> occurred for approx 30 minutes,the plant was shut down until repairs were completed. <br /> Notification calls were made to NRC(946863), SJVAPCD,County OES,County EHD and Cal-EMA(10-4058). <br /> Update notification calls were made 7/7/10,amount released and substance released was updated. <br /> E <br /> 1F1KNOWN OR ANTICIPATED HEALTH EFFECTS(Use the comments section for additional information) <br /> ® ACUTE OR IMMEDIATE(explain)Inhalation Hazard,Corrosive <br /> CHRONIC OR DELAYED(explain) <br /> ❑ NOT KNOWN(explain) <br /> ADVICE REGARDING MEDICAL ATTENTION NECESSARY FOR EXPOSED INDIVIDUALS <br /> Move victim to fresh air and contact 911 <br /> COMMENTS (INDICATE SECTION(A-G)AND ITEM WITH COMMENTS OR ADDITIONAL INFORMATION)- <br /> CERTIFICATION:1 certify under penalty of law that I have personally examined and am familiar with the information submitted and <br /> Believe the submitted information is true,accurate,and complete. <br /> REPORTING FACILITY REPRESENTATIVE(print or type)Ryan Mock,Environmental Specialist <br /> SIGNATURE OF REPORTING FACILITY REPRESENTATIVE��� L«� DATE: 7 <br />