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SAN JOAQUIN COUNTY <br /> 2' ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> r (209)468-3420• Fax: (209)464-3433• Web:www.siciov.ora/ehd <br /> �IIGpR�` <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE JEHDLOG#1 ) _ IQ <br /> EMERGENCY LEVEL: <br /> ❑X 1-No Evacuabon/Local Response Only ❑I -Evacuation and/or In-Canty MUWal Aid Needed ❑ I I I-Evacuation and/or Regional/State Mutual Aid Needed <br /> SOURCE OF INFORMATION <br /> NAME: Mike Hyland PHONE: 209-858-3371 <br /> COMPANY: Super Store Industries CITY: Lathrop <br /> ADDRESS: 12400 Louise Ave <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 2400 Louise Ave CITY Lathrop <br /> Description 0 Unincorporated <br /> DATE OF Friday, October 23, 2015 <br /> DISCHARGE: <br /> DATE 10-24-15 TIME: 1:48 am <br /> NOTIFIED: <br /> RESPONSIBLE PERSON/BUSINESS <br /> NAME OF BUSINESS: I Super Store Industries <br /> CONTACT PERSON: Tom Hughes, Operations Manager PHONE: 209-858-3365 <br /> PHYSICAL ADDRESS: 16888 McKinley Ave, Lathrop, CA 95330 <br /> MAILING ADDRESS: PO Box 549, Lathrop, CA 95330 <br /> DESCRIPTION <br /> TYPE OF DISCHARGE: I Spill from leaking refrigerator trailer diesel tank (trailer collapsed onto tank) <br /> VOLUME: 5-7 gallons <br /> CHEMICALS: Diesel <br /> CIRCUMSTANCES: Spill report and emergency response <br /> ACTION TAKEN <br /> Super Store personnel conducted ry cleanup of dieselspill onto asphalt. Cleanup waste is <br /> stored on site in hazardous waste labeled drum. <br /> SITE DISPOSITION <br /> No further action. <br /> Revised 6/01/2015 Page 1 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />