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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E. Hazelton Ave., Stockton • CA 95205 <br /> ' (209) 468-3420 • fax:(209) 468-3433 • Web:www.sjgov.org/ehd <br /> EMERGENCY RESPONSE RECORD <br /> DATE: 7/4/16 SHORTTERMN: C00041812 <br /> PREMISE ADDRESS:6649 Embarcadero Drive Dock E Slip 24 aTY:Stockton <br /> DBA:Village West Marina ICROSS STREET:Benjamin Holt <br /> PREMISE OWNER:VILLAGE WEST MARINA LLC PHONE: (209) 951-1551 <br /> OWNER'SADDRESS:1520 MAIN ST. REDWOOD CITY, CA 94063 CITY:REDWOOD CITY <br /> FACILITY CONTACT:Timothy Fontaine PHONE:(209) 951-1551 <br /> RESPONSIBLE PARTY(RP)DBA: <br /> RPNAME:John Gaetano PHONE:(650) 207-1962 <br /> RPADDRESS:2229 Piccardo Circle Stockton, CA 95207 CITY,Stockton <br /> RP CONTACT:John Gaetano PHONE:(650) 207-1962 <br /> NATURE OF RESPONSE(explosion,spill,leak,fire,or abandoned/dumped material) <br /> It is currently unknown how the vessel sank which discharged an unknown amount of fuel. The maximum <br /> capacity that vessel can carry is 30 gallons. A sheen was created by the discharged fuel covering an area <br /> of 15 feet, however the vessel has been boomed off. A salvage team will be needed to remove the vessel <br /> from the water. It is currently unknown who will be conducting clean up of the release. <br /> TIME RECEIVED:7/4/16 9:10 PM TIME OF ARRIVAL:7/5/16 9.00 AM TIME OF DEPARTURE: <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> Ads Veloso SJC EHD (209)468-3453 <br /> MATERIAL/CLASSIFICATION(CHemiuu"vaWD) <br /> IDENTIFICATION SPILLED? IsOLID LIQUID AL) I� COMMENTS <br /> 185)Fuel X DN <br /> DY DN <br /> DY DN <br /> DY ON <br /> OY ON <br /> DY ON <br /> REFERRALS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESS) DATE MAILED <br /> DATE PROP 65 COMPLETED: S DATE UAR COMPLETED: <br /> IFPERSONS EXPOSEDand/or INJURED,"PERSONAL TOX/CSUBSTANCE EXPOSURE RECORD'COMPLETED? D YES D ND <br /> ER BINDER COPIES: <br /> p( SHORT-TERM ON TOP ]( NARRATIVE X MAP O ANALYTICAL DATA X PROP 65/UAR D FILE CREATED <br /> O MANIFEST ❑ REFERRALS D CLEAN UP REPORT O OTHER AGENCY REPORTS 1 O EXPOSURE RECORD X PHOTOS <br /> ER RECORD Page 1 10/03/12 <br />