Laserfiche WebLink
0�4 ) '' <br /> " SAN JOAQUIN COUNTY <br /> = <br /> a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E. Hazelton Ave., Stockton • CA 95205 <br /> 4•:. ; (209) 468-3420 • Fax.(209) 468-3433 • Web;www.sigov.org/ehd <br /> EMERGENCY RESPONSE RECORD <br /> DATE: 2-23-16 SHORTTERM#: CODYL3BPC <br /> PREMISE ADDRESS: 18662 N Hwy 88 CITY: Lockeford <br /> DBA:Georges MP Mini Mart CROSS STREET: <br /> PREMISEOWNER:Rupl Padda - Operator PHONE:209-727-3064 <br /> OWNEWSADDRESS:18662 N Hwy 88, Lockeford, CA 95237 CITY,Lockeford <br /> FACILITY CONTACT: PHONE: <br /> RESPONSIBLE PARTY(RP)DBA:Georges BP Mini Mart <br /> RP NAME:Rupl Padda - Operator PHONE:209-727-3064 <br /> RP ADDRESS: 18662 N Hwy 88, Lockeford, CA 95237 CITY;Lockeford <br /> RP CONTACT: PHONE: <br /> NATURE OF RESPONSE(explosion,spill,leak,fire,or abandoned/dumped material) <br /> Leak of fuel from Dispenser#10 dispensing hose. <br /> TIME RECEIVED:12 noon TIME OF ARRIVAL:2 pm ITIME OF DEPARTURE:3 pm <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> Garrett Backus SJC EHD (209) 468-2986 <br /> Nassir Hassan cashier <br /> MATERIAL/CLASSIFICATION(DEMI LWWMD) <br /> IDENTIFICATION SPILLED? SOLID LIQUID GAS COMMENTS <br /> (LBS) (GAL) (W fn <br /> Diesel X D N 6 <br /> o ON <br /> o ON <br /> o ❑N <br /> o o <br /> OY ON <br /> REFERRALS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESS) DATE MAILED <br /> DATE PROP 65 COMPLETED: 2-25-16 1 DATE UAR COMPLETED: <br /> IF PERSONS EXPOSED and/or INI URED,"PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD"COMPLETED? o YES ❑ NO <br /> ER BINDER C PIES: <br /> SHORT-TERM ON TOP X NARRATIVE AL MAP O ANALYTICAL DATA X PROP 65/UAR ❑ FILE CREATED <br /> ❑ MANIFEST ❑ REFERRALS ❑ CLEAN UP REPORT ❑ OTHER AGENCY REPORTS ❑ EXPOSURE RECORD I X PHOTOS <br /> ER RECORD Page 1 10/03/12 <br />