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SAN JOAQUIN COUNTY ... <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 COPY <br /> A. EMERGENCY LEVEL: I II III PHS-EH LOG # % —D 3 <br /> (Circle One) <br /> B. SOURCE OF g4,FQIRMATION <br /> Name: it Zapka 14 670-5404 <br /> Y� <br /> P <br /> Com an ARCO Phone: <br /> Address: b <br /> Designated Employee Name: Jerry Yoshioka Phone: E29 ) 468-0335 <br /> Reporting Agency Name: San Joaquin County Environmental HealtF — <br /> Address: 304 E. Weber Ave. <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 18970 Lower Sacramento / Woodbridge <br /> (Best Physical <br /> 44Description)9o (City or County) Circle One <br /> Date of Discharge: <br /> Date Notified: 3/5/96 Time: 1447 hours <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: ARCO <br /> Contact Person: Bill Zapka or site manager Telephone: 2( 0 ) 339-8238 <br /> Physical Address: 18970 Lower Sacramento <br /> Mailing Address: <br /> E. DESCRIPTION <br /> Type of Discharge: Accidental release <br /> Volume: 5 - 10 gallons <br /> Chemicals: Gasoline <br /> Circumstances: Fuel released from dispenser while manager was changing <br /> fuel filters . <br /> F. ACTION TAKEN Dispenser shut-off. Spilled fuel absorbed and held for <br /> proper disposal . <br /> SITE DISPOSITION Dispenser is reported as not having containment beneath <br /> the dispenser . Fuel that was released beneath the dispenser remains . <br /> EH 22 013 (Rev.4/91) <br />