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Oct J4 10 10:35a Sara Joaquin C 2099536266 p.5 <br /> CALIFORNIA HAZARDOUS MATERIALS INCIDENTREPORT SYSTEM <br /> AGENCY NAME AGENCY ID NO, NCIDIsNT NO. AGENtiCY TEL NO. A Tl OE5 CONTROL NO. <br /> San Joaquin OES 39807 IR400431 {209}953-6200 97-3558 <br /> 1 <br /> NCIDE NT DATE 71NIE.NC)TIF+i£D ME COMPLETED ItDATECOMPLEIZO <br /> B 9{1011997 0330 if DIFFERENT <br /> FROM <br /> INQI7E14T DATE <br /> INCIDENT ADDRESSILOCATION CITYICOMMUNITY COUNTY E ZIP <br /> C Mackville Road South of Collier Clemens San Joaquin 95241 <br /> ]WEATHER TEMP Ty U SU :o D oPERTY MAYAGN 2v]>�1 C <br /> D ! CLEAR 84 962 County/City Road 931 Open Land Count} <br /> RELEASE FACTORS try, QF.=PMflVT INVOLVED WORILEPROPEWNTYPF <br /> 1 i inm utional Act 98 No Equip Involved 98 No Mobile Property Involved <br /> i <br /> A ONS TAKEN <br /> F Spilled material identified.contacted environmental health who wrow an abatement order <br /> I <br /> )CALOR TRADE NAME ID NO. T HAZARD CJ ASS CAS NO. <br /> Waste Diesel and soil 1993 3 mixture <br /> I <br /> IiYSICAL STATE PHYSICAL STATE QUANTITY RELEASED ENVIRONMENTAL CONTAMINATION ENT OF <br /> RETS RELEASED PHI-EASE <br /> 2 Liquid 2 Liquid –50 gallons 3 Ground 7 Beyond Property <br /> NTAMERDESCRIFT103� NTALXERTYPE OP CONTAINER CONTANER MATERIAL AIIVFRCAPAC1Tl` <br /> drum I1 Brum 11 Ground Level 4 PlasticlEberglass, 3x55 j <br /> Rigid <br /> CHEPMCAL OR TRADE NAME ID NO. OT HAZARD CLASS CAS NO. <br /> rVa <br /> YSICAL SLATE PHYSICALSTA Ib T}ANTiTY RELEASED IFNWPONMENTALCONTAULKATION R1 T 0 F <br /> TORFD RELEASED SE <br /> ONTAINER DESCRIPTION ONTALN TYP£ EL OFOh'tATNFR CpN+)TALhEAN TFRIAL N7AINERCAPACITY <br /> MORE'f HAN 2 SUBSTANCES WVOLVED' 13.YES Cl NO <br /> ADDITIONAL INFORMATION <br /> 1.A 8 C D 2. A 8 C D 9, A B C D 4. A B C D 5. A B C D 6. A R C D <br /> SPECIAL SATE <br /> STUDIES LOCAL <br /> USE - - -- - - — — ..._ _ —HAZMATI IDt~VTlF1CATTON SOURCES AT CASUALTIES <br /> EfCATERIAL <br /> 4OF *OF NOF <br /> PERSONNEL <br /> 60 Off-site Non-Fire 98 No Reference ESPONDING DEQ AMINAITQ 1NJLiIiI£S i'ATAIttIFS <br /> Services Material U&ed 0 U <br /> fiF1Vt:Y PIRSOA'NEI. Q Q U <br /> OTTiFRS <br /> CIE p{Al{)*11CFALtVEHICI E L ICENS£NO. AT6 CLE LD NO.(YIN) CAfD[1TIPUGIC�C NO. COMPANY NAME <br /> IK I conk tmk unk unk unit unk <br /> r1B <br /> OFFICERNAN[EnD NO.(PRINT OR TYPE) DATE COUNTS ATTACHEDs 91141!1997 Yes <br />