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Oct 04 10 10s35a San Joaquin C 2099536258 P.8 <br /> CALIFORNIA HAZARDOUS MATERIALS INCIDENT REPORT SYSTEM <br /> AGENCY NAME ACENCY ID NO_ CADENT NO. AGENCY TIEL NO, ITTA77E OES CONTROL NO <br /> A San Joaquin OES 39807 XSJd10907 (209)953-6200 NIA <br /> 4 TIMENfl1IF7 ME COMPLETED TEGO�APLEI <br /> TVCIDENT DATE <br /> B1l 711999 9513 1145 if DIFFERENT PROM <br /> ENT DATE <br /> iNCID YI ADDRESSlLOCATION CTTYlCOMMUNTIY COUNTY 7aP <br /> C Collier Rd.cast of MacWille Rd. Unincorporated 1 San Joaquin 95327 <br /> [ISS ISI RROUNDiNGREO %aNA EM£MT <br /> D l CLFAR 80 1 962 County/City Road 650 Agricultural County <br /> MA6SE c a .oFgWPM=jNyO1,VED - GBILE PROPFRTY TYP <br /> E31 Abandoned 98 No l quip Involved 98 No Mobile Property Involved <br /> CnONS AKEN <br /> Ih 42 ID/Analysis of hazmat;97_Haxmat response,material determined to be non hazardous <br /> CHEMICAL OIL TRADE NAME DOT ID NO. IlAZA1�O CtJ►SS CAS A'O. <br /> Gan.l..ab related material <br /> HYSICAL STATE PHYSICAL STA! QUANTT[Y RELEASED JENVIRONMENTALCDNTAMINATION EOF <br /> OR vFr¢ncFn <br /> None 8 NO RELEASE <br /> WAINFAINER'TYPE OF CONTAINER CONTAINER MATERIAL NTAitdQtCAPACITY <br /> CHEMICAL OR TRADE NAME II)NO. HAZARD CLASS CAS NO. <br /> NIA <br /> YSICALSTATE PHYSICALSTATE QUANTTTYTiFiFASI E1�IVIKONMFNFALCO�NIAMINAIIO[� SEF <br /> ORED RELEASED <br /> WAINER DESCRIPTION ONTAIN TYPE VSI.OFCON PAINER CONTAINER MATERIAL NTAINER CAPACfTY <br /> MCKE THAN 1 SUBSTANCES INVOLVED? 13 Yr=5 ENO <br /> ADDITIONAL INFORMATION <br /> H No hazardous chemical locked. <br /> LA B C D 2. A B C D 3. A B C fl 4. A S C D 5- A BCD & A B CD <br /> SPECIAL <br /> STUDDES LOCAL ATE <br /> USE — — --- --- -- ——— — — _..-- .._---- <br /> AZMATIDE%MFICATION SOURCES TCASUALSIES <br /> PERSONNVI_ REFERENCE fop #OF #OF <br /> DECONTAMINATED <br /> On-Site Non-Fire 9$ No Reference INRJRIES FATALITIES <br /> 40 70THERS <br /> DING 0 0 0 <br /> Services Material UsSed Y PERSONNEL <br /> 0 0 4 <br /> EHICI.I:MAyCI~IYEAitEHICL E LICENSE W.WA—TE fyEHICEFIRD NO.EVT CAMO TMUCACC NO. COMPANY NAME <br /> NIA <br /> RTINQ OFFICER NAMPAD NO.(PRINT ORTYPE) DATE COMMENTS ATTACHED <br /> EM <br /> Parissi,OES8 8/17/1999 NO <br />