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� <br /> SAN L.�•OAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> , 4 600 East Main Street Stockton a CA 95202-302 «� p7 <br /> (209) 468-3420 • Fax: (209) 464-01.38 ■ Web: www.sjgov.org/e <br /> �. Y ,.:.. <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE Sift A" ' E <br /> A. EMERGENCY LEVEL X I JEHD LOG# 107—i 6 <br /> B. SOURCE OF INFORMATION <br /> NAME: Dillon Collins PHONE: 209 557-6426 <br /> COMPANY: San Joaquin Valley Air Pollution Control District CITY: Modesto, CA 95356-8718 <br /> ADDRESS: 1 4800 Enterprise Way <br /> DESIGNATED EMPLOYEE NAME: PHONE: <br /> REPORTING AGENCY NAME: <br /> ADDRESS: <br /> C. LOCATION AND DATE OF DISCHARGE <br /> LOCATION: 640 North Center Street CITY Stockton X Incorporated <br /> Best Physical Description <br /> Unincorporated <br /> DATE OF DISCHARGE: November 1, 2007 <br /> DATE NOTIFIED: November 7,2007 TIME: 12:00 PM <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> NAME OF BUSINESS: Golden Bay Hardwood Floors and Roof <br /> CONTACT PERSON: Cong Quoc Pham PHONE: 415 740-4263 <br /> PHYSICAL ADDRESS: 1382 40'Avenue San Francisco CA 94122 <br /> MAILING ADDRESS: 1382 40`l'Avenue San Francisco CA 94122 <br /> E. DESCRIPTION <br /> TYPE OF DISCHARGE: Disposal <br /> VOLUME: Unknown <br /> CHEMICALS: Asbestos(approximately 60%-80% friable) <br /> CIRCUMSTANCES: Contractor removed roof containing friable asbestos and disposed of at municipal solid waste <br /> facility. <br /> F. ACTION TAKEN <br /> Contractor hired a certified abatement contractor to conduct removal and cleanup activities at the facility. <br /> SITE DISPOSITION <br /> Cleanup to be overseen by San Joaquin Valley Air Pollution Control District. EHD to follow up on disposal of waste. <br /> ER RECORD MODIFIED Revised 05/01/2007 <br />