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S.AN �,JOAQUIN Environmental Health Department <br /> ----COUNTY <br /> EMERGENCY RESPONSE RECORD <br /> Date: January 08, 2019 Short Term#: COWFKMOJU <br /> Premise Address: 23243 E Lone Tree RD City: ESCALON <br /> Premise DBA: NA Cross Street: Brennan Rd <br /> Premise Owner: PONDA ROCHA LAND CO LP Owner's Phone: Unknown <br /> Mailing Address: 23125 E LONE TREE RD Owner City: ESCALON <br /> Facility Contact: PONDA ROCHA LAND CO LP Contact Phone: Unknown <br /> RP DBA: Gabriel Campa <br /> Onsite RP Name: Gabriel Campa Onsite RP Phone: (209)566-4434 <br /> Mailing Address: 475 Helen Road RP City: Ripon <br /> RP Contact: Gabriel Campa Contact Phone: (209)566-4434 <br /> NATURE OF RESPONSE(explosion, spill, leak, fire, or abandoned/dumped material <br /> A car hit a transformer pole caused the spill of transformer oil onto the road way and the shoulder of the road. The Car <br /> ended in a field next to impacted pole and continued to leak vehicle fluid onto stagnant water. Oil sheen appear on water <br /> surface(approximately 10 x 2 ft area). <br /> Time Received: 3:00 pm Time of Arrival: 3:00 pm Time of Departure: 4:00 pm <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> Haza Saeed SJC EHD (209)952-6212 3:00 pm 4:00 pm <br /> MATERIAL/CLASSIFICATION chemical involved <br /> MATERIAL AMOUNT SOLID(Ibs) LIQUID(gal) GAS(cu k) COMMENTS <br /> Vehicle Fluids 0.50 ❑ ❑x ❑ <br /> ❑ ❑ ❑ <br /> ❑ ❑ ❑ <br /> REFERRALS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESS) DATE MAILED <br /> Date Prop 65 Completed: NA Date LIAR Completed: <br /> IF PERSONS EXPOSED and/or INJURED,"PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD"COMPLETED? ❑YES ❑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 />