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°P4 " SAN JOAQUIN COUNTY (� COPY <br /> a ENVIRONMENTAL HEALTH DEPARTMENT <br /> Q, y <br /> : �Iy _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �.+ "P•� (209)468-3420•Fax:(209) 464-3433 • Web:www.sigov.org/ehd <br /> 9<<F OPN) <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE EHDLOG# <br /> EMERGENCY LEVEL: <br /> ❑X 1-No Evacuation/Local 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: Fatinah Zareef PHONE: (209) 953-7311 <br /> coN1pANY: San Joaquin County Environmental Health Department CITY: <br /> Stockton <br /> ADDRESS: 1868 E. Hazelton Ave. <br /> DESIGNATED EMPLOYEE NAME: Fatinah Zareef PHONE: (209) 953-7311 <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: <br /> Best Physical Inside the Unified Grocers Warehouse aisle 49 CITY Stockton Incorporated <br /> Description <br /> ❑ Unincorporate <br /> DATE OF dMa 23, 2016 <br /> DISCHARGE: y <br /> DATE May 23, 2016 <br /> NOTIFIED: y TIME: 12:30 pm <br /> RESPONSIBLE PERSON/BUSINESS <br /> NAME OF BUSINESS: Unified Grocers <br /> CONTACT PERSON: Thelma Sass 209 47 <br /> PHONE: ( ) 0-1922 <br /> PHYSICAL ADDRESS: 1990 PI00011 Road, $tOCktOn, CA 95215 <br /> MAILING ADDRESS: 1990 PICC011 Road, Stockton, CA 95215 <br /> DESCRIPTION <br /> TYPE OF DISCHARGE: Spill <br /> VOLUME: 20 gallons <br /> CHEMICALS: Household Bleach <br /> CIRCUMSTANCEs: 20 gallons of bleach spilled on floor of warehouse <br /> ACTION TAKEN <br /> pl is G I !:I n ! an cleanup company in route. <br /> SITE DISPOSITION <br /> Clean up to be conducted soon. <br /> Revised 6/0 112 01 5 Page 1 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />