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0 5l4�!lw.;.o SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E Main Street Stockton ■ CA 95202 <br /> (209)468-3420■Fax:(209)464-0138• Web:www.sjgov;ora/ehd <br /> EMERGENCY RESPONSE RECORD <br /> DATE: Tuesday, June 22, 2010 SHORT TERM* ool 22,2 <br /> PREMISE ADDRESS: 1021 INDUSTRIAL DR CITY: STOCKTON <br /> DBA: I CORN PRODUCTS INTERNATIONAL, INC. <br /> PREMISE OWNER: I SAME AS ABOVE PHONE: 982-1920 X233 <br /> OWNER'SADDRESS: SAME AS PREMISE CITY: <br /> FACILITY CONTACT: ROGER HOFFDAHL PHONE: SAME AS ABOVE <br /> RESPONSIBLE PARTY(RP)DBA: SAME AS ABOVE <br /> RP NAME: PHONE: <br /> RP ADDRESS: CITY: <br /> RP CONTACT: PHONE: <br /> NATURE OF COMPLAINT(explosion, spill,leak, fire,or abandoned/dumped material <br /> A SPILL OCURRED WHEN A DELIVERY HOSE COUPLING CAME LOOSE. WATER TREATMENT CHEMICAL <br /> WITH A PH OF 1.8 <br /> TIME RECEIVED: 1 0915 TIME OF ARRIVAL: 0915 TIME OF DEPARTURE: 1500 <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> WILSON SUN CORN PRODUCTS 547-8252 0900 - I <br /> ROGER HOFFDAHL CORN PRODUCTS 982-1920 X233 0900 - <br /> LEE NALCO <br /> IDENTIFICATION OF MATERIAL{CHEmicaLmmvm) (� <br /> SUBSTANCE FORM El SOLID ❑ POWDER GAS x LIQUID ❑ GRANULE <br /> REFERRALS TO: DATE MAILED: <br /> DATE COMPLETED.—PROP 65: Jun 22, 2010 LIAR: <br /> PERSONS EXPOSED and/or INJURED <br /> NAME ADDRESS PHONE <br /> NONE <br /> "PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD"COMPLETED? ❑ YES ❑x NO <br /> E.R.BINDER COPIES: <br /> x SHORT-TERM ON TOP x NARRATIVE ANALYTICAL DATA I [RI PROP 65/UAR <br /> EXPOSURE RECORD x MANIFEST CLEAN UP REPORT I Ll OTHER AGENCY REPORTS <br /> LW REFERRALS x MAP FILE CREATED <br /> ER RECORD 06/01/10 <br /> Page 1 <br />