Laserfiche WebLink
SANJ O a Q U I N Environmental Health Department <br /> EMERGENCY RESPONSE RECORD <br /> Date: February 04, 2019 ShortTerm#: COTTPEME1 <br /> Premise Address: 2802 Country Club BLVD City: STOCKTON <br /> Premise DBA: Cross Street: Fontana Ave. <br /> Premise Owner: SPENO, NICHOLAS A& DIANE M TR ETAL Owner's Phone: <br /> Mailing Address: 1371 OAKLAND BLVD#200 Owner City: WALNUT CREEK <br /> Facility Contact: SPEND, NICHOLAS A& DIANE M TR ETAL Contact Phone: <br /> RP DBA: Safeway Fuel Center 1769 <br /> Onsite RP Name: Ron Lee Onsite RP Phone: (925)469-7513 <br /> Mailing Address: 5918 Stoneridge Mall Rd. RP City: Pleasanton <br /> RP Contact: Ron Lee Contact Phone: (925)469-7513 <br /> NATURE OF RESPONSE (explosion, spill, leak, fire, or abandoned/dumped material <br /> Approximately 5 gallons of gasoline was released from fuel tank in a truck. <br /> Time Received: 11:42 am Time of Arrival: 12:09 pm Time of Departure: 12:24 pm <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> Jason Gaitan SJCEHD (209)468-9848 12:09 pm 12:24 pm <br /> John Alaniz SJCEHD (209)468-3147 12:09 pm 12:24 pm <br /> Sandra Harbaugh Safeway (209) 461-5555 <br /> MATERIAL/ CLASSIFICATION chemical involved <br /> MATERIAL AMOUNT SOLID(lbsl LIQUID(aaD GAS(cu ft) COMMENTS <br /> Gasoline 5.00 ❑ 0 ❑ <br /> ❑ ❑ ❑ <br /> ❑ ❑ ❑ <br /> REFERRALS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESS) DATE MAILED <br /> Date Prop 65 Completed: February 05, 2019 Date LIAR Completed: <br /> IF PERSONS EXPOSED and/or INJURED,"PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD"COMPLETED? ❑YES I�NO <br /> Page 1 of 2 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />