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i <br /> i <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> N' { 600 East Main Street Stockton ■ CA 95202-302 «J p' <br /> (209) 468-3420 ■ Fa : (209) 464-0138 • Web: www.sjgov.o ie <br /> Fax: <br /> 9 �q�lJF p'g��P <br /> a NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> A. EMERGENCY LEVEL IX II EHD LOG# <br /> B. SOURCE OF INFORMATION <br /> NAME: I Dillon Collins PHONE: 209 557-6426 <br /> COMPANY: San Joaquin Valley Air Pollution Control District CITY: Modesto, CA 95356-8718 <br /> ADDRESS: 1 4800 Enterprise Way <br /> DESIGNATED EMPLOYEE NAME: PHONE: <br /> REPORTING AGENCY NAME: <br /> ADDRESS: <br /> C. LOCATION AND DATE OF DISCHARGE <br /> LOCATION: 640 North Center Street CITY Stoclaon X IncorWrated <br /> &u Pttysica]Description <br /> UniDcorporated <br /> DATE OF DISCHARGE: November 1, 2007 <br /> DATE NOTIFIED: November 7,2007 TIME: 12:00 PM <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> NAME OF BUSINESS: Golden Bay Hardwood Floors and Roof <br /> CONTACT PERSON: Co2a Quoc Pham PHONE: 415 740-4263 <br /> PHYSICAL ADDRESS: 1382 401 Avenue San Francisco CA 94122 <br /> MAILING ADDRESS: 1382 4yh Avenue San Francisco CA 94122 <br /> E. DESCRIPTION <br /> TYPE OF DISCHARGE: Disposal <br /> VOLUME: Unknown <br /> CHEMICALS: Asbestos a roximatel 60%-80% friable <br /> CIRCUMSTANCES: Contractor removed roof containing friable asbestos and disposed of at municipal solid waste <br /> faciliLy. <br /> F. ACTION TAKEN <br /> Contractor Hired a certified abatement contractor to conduct removal and cleanup activities at the facility, <br /> SITE DISPOSITION <br /> Cleanup to be overseers by San Joaquin Valley Air Pollution Control District. EHD to follow up on disposal of waste. <br /> P <br /> ER RECORD MODIFIED Revised 05/01/2007 <br />