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CO0043200
EnvironmentalHealth
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2500 – Emergency Response Program
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CO0043200
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Last modified
7/2/2020 11:26:51 PM
Creation date
2/11/2019 10:41:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0043200
PE
2546
STREET_NUMBER
1990
Direction
N
STREET_NAME
PICCOLI
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10121001
ENTERED_DATE
4/3/2017 12:00:00 AM
SITE_LOCATION
1990 N PICCOLI RD
RECEIVED_DATE
4/3/2017 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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ADMIN
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FilePath
\MIGRATIONS\P\PICCOLI\1990\CO0043200.PDF
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EHD - Public
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opo t" •s SAN JOAQUIN COUNTY COPY <br /> Z• ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 4 <br /> (209)468-3420 • Fax.(209)464-3433• Web:www.sigov.org/ehd <br /> <IFORN <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE JEHDLOG#1 17-o-q-.3--] <br /> EMERGENCY LEVEL: <br /> RI-No Evacuationi-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: Thelma Sass PHONE: 209-470-1922 <br /> coMPANY: San Joaquin County Environmental Health Department clrY: Stockton <br /> ADDRESS: 1868 E. Hazelton Ave. <br /> DESIGNATED EMPLOYEE NAME: Haze Saeed PHONE: 209-953-6212 <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: 0 Incorporated <br /> Best Physical 1990 Piccoli Road CITY Stockton <br /> Description ❑ unincorporated <br /> DATE OF 0 <br /> DISCHARGE: 4/03/2017 <br /> DATE 04/03/2017 <br /> NOTIFIED: TIME: 08:30 am <br /> RESPONSIBLE PERSON/BUSINESS <br /> NAME OF BUSINESS: Unified GfOCerS <br /> CONTACT PERSON: Thelma Sass PHONE: 209-470-1922 <br /> PHYSICAL ADDRESS: 1990 Piccoli Rd, Stockton, CA 95215 <br /> MAILING ADDRESS: 1990 Piccoli Rd, Stockton, CA 95215 <br /> DESCRIPTION <br /> TYPE OF DISCHARGE: Spill <br /> VOLUME: Approximately 168 gallons <br /> CHEMICALS: Household Bleach <br /> CIRCUMSTANCES: Forklift operator was moving a pallet of bleach from an upper level and due to unknown reason it fell onto the ground <br /> ACTION TAKEN <br /> Clean up was completed. <br /> SITE DISPOSITION <br /> EHD is waiting for the disposal records. <br /> Revised 6/01/2015 Page 1 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />
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