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SAN 10 A Q U I N Environmental Health Department <br /> U i,,.J I I- <br /> EMERGENCY RESPONSE RECORD <br /> Date: May 27, 2019 Short Term#: COQDPHYHI <br /> Premise Address: 15250 N THORNTON RD City: LODI <br /> Premise DBA: Cross Street: HWY 12 <br /> Premise Owner: LOVES COUNTRY STORES CALIFORNIA Owner's Phone: <br /> Mailing Address: 15 W.6TH ST#2400 Owner City: TULSA <br /> Facility Contact: LOVES COUNTRY STORES CALIFORNIA Contact Phone: <br /> RP DBA: PAT FRUTH INC <br /> Onsite RP Name: MIKE SWALLEY Onsite RP Phone: <br /> Mailing Address: 17307 COUNTY RD 7 NW RP City: CLEAR WATER <br /> RP Contact: PAT FRUTH Contact Phone: (320)558-4210 <br /> NATURE OF RESPONSE(explosion, spill, leak, fire, or abandoned/dumped material <br /> ACCORDING TO WOODBRIDGE FIRE DEPT,AN ESTIMATED 15 GALS OF DIESEL, 5 GALS OF MOTOR OIL, AND 3 <br /> GALS OF ANTIFREEZE SPILLED ONTO ASPHALT AND ENTERED A DRAIN ON THE LOVE'S TRAVEL STOP PARKING <br /> LOT DUE TO FIRE DAMAGE TO A SEMI-TRAILER TRUCK.THE FIRE WAS SUSPECTED TO BE CAUSED BY A <br /> DIESEL-OPERATED HEATER ON THE TRUCK. THE SADDLE TANKS ON THE TRUCK DID NOT RUPTURE. <br /> Time Received: 12:54 pm Time of Arrival: 1:42 pm Time of Departure: 6:42 pm <br /> PERSONS AT SCENE <br /> NAME AGENCY PHONE TOA TOD <br /> ERIC JOHNSON WOODBRIDGE FIRE (209)329-0632 2:30 pm <br /> MIKE SWALLEY PAT FRUTH INC <br /> WILLIAM SHAW LOVES TRAVEL STOP (916)616-9594 <br /> KEVIN SMITH GREAT WESTERN CASUALTY CO (916)247-1748 4:30 pm <br /> ED LEITCH LMH (916)847-1763 4:30 pm 11:30 pm <br /> MATERIAL/CLASSIFICATION chemical involved <br /> MATERIAL AMOUNT SOLID(lbs) LIQUID(gal) GAS(cu ft) COMMENTS <br /> DIESEL 50.00 ❑ ❑x ❑ UPDATE:AMOUNT RELEASED CHANGED F <br /> MOTOR OIL 5.00 ❑ ❑x ❑ <br /> ANTIFREEZE 3.00 ❑ O ❑ <br /> REFERRALS AND NOTIFICATIONS <br /> REFERRED TO(NAME AND ADDRESS) DATE MAILED <br /> Date Prop 65 Completed: May 28, 2019 Date UAR 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 />