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SAN J O A Q U I N Environmental Health Department <br /> COUNTY <br /> EMERGENCY RESPONSE RECORD <br /> Date: August 07,2018 Short Term#: COMBPSGNB <br /> Premise Address: 3800 W COUNTRY CLUB BLVD City: STOCKTON <br /> Premise DBA: STOCKTON GOLF&COUNTRY CLUB Cross Street: <br /> Premise Owner: STOCKTON GOLF&COUNTRY CLUB Owner's Phone: <br /> Mailing Address: 3800 W.COUNTRY CLUB BLVD. Owner City: STOCKTON <br /> Facility Contact: STOCKTON GOLF&COUNTRY CLUB Contact Phone: <br /> RP DBA: STOCKTON GOLF&COUNTRY CLUB <br /> Onsite RP Name: RICH HOWARTH Onsite RP Phone: (209)466-4313 13 <br /> Mailing Address: 3800 W.COUNTRY CLUB BLVD. RP City: STOCKTON <br /> RP Contact: RICH HOWARTH Contact Phone: (209)466-4313 13 <br /> NATURE OF RESPONSE(explosion,spill, leak,fire, or abandoned/dumped material <br /> UNKNOWN TYPE AND QUANTITY OF CHEMICAL INSIDE A TRASH COMPACTOR OUTSIDE THE KITCHEN AT <br /> STOCKTON GOLF&COUNTRY CLUB, CAUSING FUMES TO BE RELEASED FROM THE COMPACTOR. <br /> Time Received: 12:30 pm Time of Arrival: 1:00 pm Time of Departure: 2:42 pm <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> STOCKTON FIRE DEPT. STOCKTON FIRE DEPT. 1:30 pm <br /> RICH HOWARTH STOCKTON GOLF&COUNTRY C (209)466-4313 13 <br /> ELIANNA FLORIDO SJC EHD (209)468-0343 1:00 pm 2:42 pm <br /> MATERIAL/CLASSIFICATION chemical involved <br /> MATERIAL AMOUNT SOLID(Ibsl LIQUID(call GAS(cu ft) COMMENTS <br /> UNKNOWN CHEMICAL ❑ ❑ ❑ <br /> ❑ ❑ ❑ <br /> REFERRALS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESSI DATE MAILED <br /> N/A <br /> Date Prop 65 Completed: January 03, 2019 Date UAR Completed: <br /> IF PERSONS EXPOSED and/or INJURED,"PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD'COMPLETED? ❑YES ❑NO <br /> Page 1 of 2 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />