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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.sigov.org/ehd <br /> EMERGENCY RESPONSE RECORD <br /> DATE: 1/26/2015 SHORT TERM#: C00039141 <br /> PREMISE ADDRESS:Jack Tone Rd. CITY: Manteca <br /> DBA: <br /> NA ICROSS STREET: Hwy 120 <br /> PREMISE OWNER: PHONE: NA <br /> OWNER'S ADDRESS:NA CITY:NA <br /> FACILITY CONTACT:NA PHONE:NA <br /> RESPONSIBLE PARTY(RP)DBA:NA <br /> RP NAME:NA PHONE:NA <br /> RP ADDRESS:NA CITY:NA <br /> RP CONTACT:NA PHONE:NA <br /> NATURE OF RESPONSE(explosion,spill,leak,fire,or abandoned/dumped material) <br /> Automotive battery on roadside <br /> TIME RECEIVED:0800 TIME OF ARRIVAL:0900 TIME OF DEPARTURE. 1 000 <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> Jamie DeLaRosa SJC EHD (209) 953-6214 0900 1000 <br /> MATERIAL/CLASSIFICATION(CHEMICAL INVOLVED) <br /> IDENTIFICATION SPILLED? SOLID LIQUID GAS COMMENTS <br /> (LBS) (GAL) (CU FT) <br /> automotive battery ❑Y X N unable to locate <br /> o ❑N <br /> o o <br /> o o <br /> ❑Y o <br /> o c <br /> REFERRALS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESS) DATE MAILED <br /> NA <br /> DATE PROP 65 COMPLETED: DATE UAR COMPLETED: <br /> IF PERSONS EXPOSED and/or INJURED,"PERSONAL TOXICSUBSTANCE EXPOSURE RECORD"COMPLETED? ❑ YES ❑ NO <br /> ER BINDER COPIES: <br /> X SHORT-TERM ON TOP X NARRATIVE ❑ MAP ❑ ANALYTICAL DATA ❑ PROP 65/UAR ❑ FILE CREATED <br /> ❑ MANIFEST ❑ REFERRALS ❑ CLEAN UP REPORT ❑ OTHER AGENCY REPORTS ❑ EXPOSURE RECORD 1 ❑ PHOTOS <br /> ER RECORD Page 1 10/03/12 <br />