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qu iiy\ <br /> 2'�P-fit c � SAN JOAQUIN COUNTY <br /> ": ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Fo%' (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd <br /> WASTE DISCHARGE/SPILL RESPONSE <br /> NOTICE TO ABATE <br /> FACILITY TYPEINAME: a t - DATE: <br /> SITE ADDRESS: $ CITY: ZIP CODE: cj <br /> OWNER/OPERATOR: �ELEPHONE: 5S <br /> TYPE OF A NTNG CENTER RESPONSE ❑ OTHER PROGRAM v RECORD <br /> INSPECTION: OMPLAINT L3 CONSULTATION ❑ ROUTINE ELEMENT: �QJ `I�s ID#: 1 G <br /> NATURE OF WASTE DISCHARGE/SPILL RELEASE: Crc-'-K . uu <br /> -__ ---- - <br /> OBSERVATIONS: OCI yC tJ Q1��CpX Mp• \� 10 Qp,\�1�/1 CJS <br /> �kc��5 � �Ci v�vJ o-� � Un�o►va..� oKa• �c.;1��-- I I�� <br /> L6- \ ��� o Ufi � rer+►n.i� U <br /> VIOLATIO <br /> Discharge of any Waste, including Sewage <br /> (CA Health and Safety Code 5411) <br /> ❑ Discharge of Waste or Sewage to Water or within 150' of Waterway <br /> (SJC Ordinance Code Sections 9-1125.3, 9-1125.4) <br /> ❑ Improper Disposal of a Hazardous Waste <br /> (CA Health and Safety Code 25189.5) <br /> ❑ Permitting or Maintaining a Nuisance <br /> (SJC Ordinance Code Section 8-5100) <br /> ❑ Other: <br /> CORRECTIVE ACTIONS/ORDER: <br /> Immediately contain, clean up, and dispose of the waste at an authorized, permitted location. <br /> Ensure that clean up personnel possess adequate training. <br /> ❑ Investigate and abate contamination under the oversight of the appropriate lead agency. <br /> ubmit copies of hazardous waste manifests/disposal records to the EHD within 30 days. <br /> ❑ Other: Correct By: <br /> COST RECOVERY: All EHD Staff Time Associated with this Spill Response is Billed to the Responsible Party at <br /> the Current Hourly Rate. FailljLa4 Comply with this Notice may Result in Formal Enforcement Action. <br /> INSPECTED BY: PRINT NAME: <br /> SIGNATURE OF ENVIRO LTH STAFF <br /> RECEIVED BY: DATE: <br /> SIGNATUR11 F WN OPE OR <br /> FHn?5-001 Rev 05/19116 Spill Response NOTICE TO ABATE <br />