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ow. <br /> t <br /> ACTIVITY LOG (ICS 214) <br /> r <br /> 1. Incident Name: 2. Operational Period: Date From:11/19/2012 Date To:11/119/2012 <br /> Super Store industries Time From: Time To: <br /> 3. Name: 4. ICS Position: 5. Home Agency (and Unit): i. <br /> Jeffrey Wong <br /> 6. Resources Assigned: <br /> Name ICS Position Home Agency (and Unit) <br /> t <br /> k <br /> I <br /> L <br /> i <br /> I 7.Activity Log: <br /> i <br /> Date/Time Notable Activities <br /> 111 12012.12:20P Approximately 2 gallons of anti-freeze released when hose on truck broke. No surface <br /> water or storm drain was impacted. Absorbent was used to pick up the release on asphalt. <br /> Absorbent has been collected and stored in a hazardous waste container to be disposed <br /> by contractor (Clean Harbor) in 30 days. Gave Kelley a copy of inspection report requiring <br /> submittal of disposal record. Generated Prop 65 <br /> �I ZaIZ v p '^� >e. <br /> &—I Ar d <br /> L 2t Zdce t.ve eatvin <br /> 4b�C4-e'� IAm 4-1/ .k- =&LL t7 mAe-k Crb <br /> ct <br /> r <br /> r , <br /> 0 C1 L90 Z -h2) 'T I <br /> P40 0w k' Z//6 WQLAA CO <br /> 8. Prepared by: Name: Jeffre WonG Position/Title: Sr REHS Signature: <br /> ICS 214, Page 1 Date/Time: 2012 November 19 f El Ir Z <br /> i <br /> 1 <br /> r <br />