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"��Q..IN SAN JOAQUIN COUNTY <br /> SO'' �•COG <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> " 1868 E. Hazelton Ave., Stockton • CA 95205 <br /> idle fir' <br /> ..'� j (209) 468-3420 • Fax:(209) 468-3433 • Web:www.sjgov.org/ehd <br /> 9ti�aai' <br /> EMERGENCY RESPONSE RECORD <br /> EDBA: <br /> -21-2015 SHORTTERM#: <br /> Stockton <br /> E ADDRESS: <br /> 801 Diamond Street, CITY <br /> NSFCROSSSTREET: <br /> BNSF PHONE:E OWNER: FORT WORTH, TX <br /> 2500 LOU MENK DRIVE CITY: <br /> OWNER'S ADDRESS: 817-352-2833 <br /> FACILITY CONTACT: <br /> Ketcham PHONE: <br /> RESPONSIBLE PARTY(RP)DBA:BNSF <br /> RP NAME: <br /> as above PHONE: <br /> CITY: <br /> as above <br /> RP ADDRESS: 360-553-8672 <br /> EEE <br /> Justin Piper PHONE: <br /> RP CONTACT: p <br /> NATURE OF RESPONSE(explosion,spill,leak,fire,or abandoned/dumped material) <br /> Leak of Metam Sodium from the vent of the rail car (UTLX 200074) and the subsequent dripping onto the <br /> soil below <br /> TIME RECEIVED: <br /> 12:50 am I-{`. OLnj TIMEOFARRIVAL: TIME OF DEPARTURE: <br /> PERSONS AT SCENE TOA LOD <br /> NAME AGENCY PHONE <br /> Muniappa Naidu SJC EHD <br /> Sa -sjc t5fD 9 3 <br /> MATERIAL/CLASSIFICATION(CH[MI WNWLVFD) SOLID LIQUID GAS <br /> SPILLED? COMMENTS <br /> IDENTIFICATION (Le51 IeAU (NFT) <br /> Metam Sodium X D N < 5 gal <br /> c ❑N <br /> o ❑IN <br /> ❑Y ON <br /> u o <br /> o oN <br /> REFERRALS AND NOTIFICATIONS DATE MAILED <br /> REFERRED TO(NAME AND ADDRESS) <br /> DATE PROP 65 COMPLETED: 8-21-2015 DATE UAR COMPLETED: <br /> IF PERSONS EXPOSED and/or INJURED,"PERSONAL TOXICSUBSTANCEEXPOSURE RECORD"COMPLETED? ❑ YES NO <br /> ER BINDER COPIES: <br /> X SHORT-TERM ON TOP )K NARRATIVE X MAP ❑ ANALYTICAL DATA PROP 65 LIAR ❑ FILE CREATED <br /> X MANIFEST ❑ REFERRALS O CLEANUP REPORT O OTHER AGENCY REPORTS O EXPOSURE RECORD X PHOTOS 10/03/12 <br /> ER RECORD Page 1 <br />