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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: 5/24/2017 SHORTTERM#: C00043527 <br /> PREMISE ADDRESS:6649 Embarcadero Dr. ICITY,Stockton <br /> DBA:Village West Marina CROSS STREET:Cumberland Pl. <br /> PREMISE OWNER:VIllage West Marina PHONE: (209) 951-1551 <br /> OWNER'S ADDRESS:6649 Embarcadero Dr. CITY.Stockton <br /> FACILITY CONTACT:Timothy Fontaine PHONE:(209) 951-1551 <br /> RESPONSIBLE PARTY(RP)DBA:Pleasure Craft Vessel <br /> RP NAME:Greg Ebenhack PHONE:(209) 952-9791 <br /> RPADDRESS:3502 14 Mile Dr. CITY.Stockton <br /> RP CONTACr:Greg Ebenhack PHONE:(209) 952-9791 <br /> NATURE OF RESPONSE(explosion,spill,leak,Fre,or abandoned/dumped material) <br /> Release of oil into water from a leaking pleasure craft vessel propeller. Booms and absorbent have been <br /> applied. <br /> TIME RECEIVED: 12:45 PM TIME OF ARRIVAL:2.07 PM TIME OF DEPARTURE:2.53 PM <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> Elianna Florido SJC EHD 209-468-0343 2:07 PM 2:53 PM <br /> Garrett Backus SJC EHD 209468-2986 2:07 PM 2:53 PM <br /> Timothy Fontaine Village West Marina 209-951-1551 unknown unknown <br /> MATERIAL/CLASSIFICATION IUIEMIBL[NV LWDI <br /> IDENTIFICATION SPILLED? SOLID LIQUID GAS COMMENTS <br /> (LBS) (GAL) ICU FTI <br /> Oil X D N <1 Less than 1 gallon of oil released <br /> D ON <br /> o ❑N <br /> o c <br /> D ON <br /> o DN <br /> REFERRAILS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESS! DATE MAILED <br /> N/A <br /> DATE PROP 65 COMPLETED: N/A IDATE LIAR COMPLETED: NIA <br /> IF PERSONS EXPOSED and/or INJURED,"PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD"COMPLETED? ❑ YES D NO <br /> ER BINDER COPIES: <br /> JR SHORT-TERM ON TOP X NARRATIVE X MAP n ANALYTICALDATA 0 PROP 65/UAR O FILECREATED <br /> $ MANIFEST O REFERRALS U CLEAN UP REPORT O OTHER AGENCY REPORTS O EXPOSURE RECORD pj PHOTOS <br /> ER RECORD Page 1 10/03/12 <br />