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'o " SAN JOAQUIN COUNTY copy <br /> 2` ?� ENVIRONMENTAL HEALTH DEPARTMENT <br /> Q: <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> (209)468-3420 •Fax: (209)464-3433• Web:www.sigov.orq/ehd <br /> 9�/FOS <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE JEHDLOG#1 <br /> EMERGENCY LEVEL: <br /> 111-No Evacuafiond_ocal Response Only ❑II-Evacuation and/or In-County Mutual Aid Needed ❑III-Evacuation and/or Regional/State Mutual Aid Needed <br /> SOURCE OF INFORMATION <br /> NAME: Tim Fontaine PHONE: 209-951-1551 <br /> COMPANY: Village West Marina CITY: Stockton <br /> ADDRESS: 6649 Embarcadero Dr, Stockton CA 95219 <br /> DESIGNATED EMPLOYEE NAME: Garrett Backus PHONE: 209-468-2986 <br /> REPORTING AGENCY NAME: San Joaquin County Environmental Health Department <br /> ADDRESS: 1868 E. Hazelton Ave., Stockton, CA 95205-6232 <br /> LOCATION AND DATE OF DISCHARGE <br /> LOCATION. Incorporated <br /> Best Physical Village West Marina, slip E24 cITY Stockton <br /> Description ❑ Unincorporated <br /> DATE Tuesday,OF <br /> May 23, 2017 <br /> DISCHAARGE: y <br /> DATE Tuesday, May 23, 2017 <br /> NOTIFIED: y y TIME: 4:15 pm <br /> RESPONSIBLE PERSON/BUSINESS <br /> NAME OF BUSINESS: I Pleasure Craft Owner <br /> CONTACT PERSON: Austin Roberts-boat owner PHONE: 209-609-0013 <br /> PHYSICAL ADDRESS: 6223 Shenandoah Place, Stockton CA 95219 <br /> MAILING ADDRESS: 6223 Shenandoah Place, Stockton CA 95219 <br /> DESCRIPTION <br /> TYPE OF DISCHARGE: I Spill/Leak <br /> VOLUME: unknown <br /> CHEMICALS: oil <br /> CIRCUMSTANCES: possible leak from boat, potential vandalism <br /> ACTION TAKEN <br /> Village West Marina and Austin Roberts conducted cleanup of the oil sheen. <br /> SITE DISPOSITION <br /> Cleanup ongoing. <br /> Revised 6/01/2015 Page 1 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />