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Feb 23 05 10: 29a San Paquin County OES 20946822✓0 P. 30 <br /> SAN JOAQUIN COUNTY OFFICE OF EMERGENCY SERVICES <br /> INCIDENT REPORT 222 E.Weber Ave.,Stockton,CA 95202 (209)468-3962 <br /> ADDITIONAL INFORMATION OR FURTHER DESCRIPTION OF CHARACTERISTICS OF EMERGENCY <br /> E County report file after receiving State Spill Report. Responsible party did not notify County OES. <br /> F <br /> ACTIVATED DATFJTIME INITIALLY AT SCENE/ROC <br /> DATE TIME <br /> JOINT TEAM ACTIVATED MEMBERS ON SCENE <br /> n NO <br /> FDATEMME ACTIVATED <br /> IDENTIFICATION SOURCES MITIGATION/REMOVAL ACTIONS <br /> REFERENCE MATERIAL <br /> None <br /> .. <br /> SUMMARY OFACTIONS TAKEN BY DES PERSONNEL <br /> Take report from State OES Spill Report#05.0140 <br /> G <br /> CASUALTIES AND DAMAGE CAUSED AS A RESULT OF INCIDENT <br /> FATALITIES INJURIES DECONTAMINATED STRUCTURES OTHER LOSSES/COMMENTS <br /> DESTROYED <br /> RESPONDING N/A N/A WA N/A N/A <br /> H AGENCY PERSONNEL <br /> AFFECTED BUSINESS NIA WA N/A STRUCTURES <br /> DAMAGED <br /> _ PUBLIC N/A N/A WA WA <br /> AGENCY NOTIFICATIONS AND/OR REFERRALS <br /> NAME OF AGENCY DATE OF NOTIFICATION TIME OF NOTIFICATION NAME OF REPRESENTATIVE <br /> NOTIFIED <br /> I <br /> OTHER DOCUMENTS OR INFORMATION DEVELOPED FROM INCIDENT <br /> J <br /> REPORTING OFFICER NAME DATE FILED COMMENTS j <br /> IDENI H ICATION NO. ATTACHED <br /> K ABentley,OES5 1/11/2004 NO <br /> Page 2 <br />