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State of California-California Environmental Protection Agenc:y AgencyGe2artment of Toxic Substances Control <br /> ENVIROSTOR COMPLAINT FORM CAL EPA COMPLAINT td u:11992 CASE #: 13-0913-0622 <br /> 1) Investigate the District for: <br /> a. Failure to comply with applicable hazardous material guidelines and California law; <br /> b. Failure to provide for the appropriate safety of their employees-, and <br /> c. Failure to disclose the exposure to certain chemicals to their employees <br /> 2) Visit the White Slough facility and determine what chemicals/treatments have been applied in the area, <br /> whether documented in writing or not <br /> 3) Test the bodies of water and surrounding environment for undocumented use of hazardous chemicals, <br /> including general microbiological testing, bacterial pathogens, parasites and human viruses <br /> 4) Test the bodies of water and surrounding environment for undocumented and/or inappropriate use of <br /> Formalin specifically <br /> 5) Ensure the District educates and trains employees on the chemicals used, including their exposure risk <br /> and appropriate stabilizing medical treatment upon exposure, and that these actions are documented as <br /> required by law <br /> 6) Ensure the District reports all chemical treatments to the appropriate governmental agencies <br /> 7) Provide me with information regarding the handling of this complaint <br /> Please note I have documentation available to support my complaints, including information regarding the <br /> use of Formalin at the White Slough facility. i tried to complete the online form and was unable to do so. <br /> Therefore, I respectfully request that an investigator from your office contact me and pursue this <br /> investigation as soon as possible. <br /> Thank you, <br /> Tiffany Anderson <br /> 2 N. Avena Avenue <br /> Lodi, CA 95240 <br /> (209) 625-8587 <br /> cc: Karen Ross, Secretary, Department of Food and Agriculture <br /> Marty Morgenstern, Secretary, Labor and Workforce Developmental Agency <br /> Christine Baker, Director, Department of Industrial Relations <br /> Alleged Responsible Party (ARP): <br /> Company Name: SAN JOAQUIN Co MOSQUITO&VECTO Contact Name: Ed Lucchesi, John R. Stroh(Ret. 2012)„ & B <br /> Address: <br /> 7759 S AIRPORT WAY <br /> Stockton, CA 952060000 <br /> San Joaquin County <br /> Response Type 1'Date: 9/6/2013 <br /> Referred To: San Joaquin County Environmental Health- Kasey Foley-kfoley@sjc--hd.com <br /> Generated by EnviroStor-h(tpllwww envirostar dtscca qov PDF Generated an 91612013 2.50:37PM <br />