Laserfiche WebLink
..0 •.i <br /> CALIFORNIA HAZARDOUS MATERIALS INCIDENT REPORT SYSTEM <br /> 11 AGENCY NAME AGENCY ID NO. INCIDENT NO. AGENCY TEL NO. OES CONTROL NO. <br /> San Joaquin OES 39807 XSJ-01301 (209)468-3962/3969 01-02951 <br /> INCIDENT DATE TIME NOTIFIED TIME COMPLETED DATE COMPLETED <br /> B 5/15/2001 1310 1430 If DIFFERENT FROM <br /> INCIDENT DATE <br /> INCIDENT ADDRESS/LOCATION CITY/COMMUNITY COUNTY ZIP <br /> C Fremont St. at Stokes Ave. Stockton San Joaquin 95215 <br /> WEATHER I TEMP I PROPERTY USE I SURROUNDING AREA 1PROPERTY MANAGEMENT <br /> D 1 CLEAR 962 County/City Road 600 Industrial, Utility County <br /> RELEASE FACTORS ITYPF OF E UIPMENT INVOLVED IMOBILE PROPERTY TYPE <br /> E 98 No Release 98 No Equip Involved 98 No Mobile Property Involved <br /> ACTIONS TAKEN <br /> F 36 Transport,41 Remove Hazard(Neutralize),42 ID Haz Mat,63 Notify Other Agency,64 Provide Public Info. <br /> CHEMICAL OR TRADE NAME DOT ID NO. DOT HAZARD CLASS CAS NO. <br /> Waste Oil 1270 <br /> HYSICAL STATE PHYSICAL STATE JQUANTITY RELEASED ENVIRONMENTAL CONTAMINATION JEXTENT OF <br /> TORED RELEASED RELEASE <br /> 2 Liquid 8 NO RELEASE <br /> r CONTAINER DESCRIPTION CONTAINER TYPE LEVEL OF CONTAINER CONTAINER MATERIAL 1CONTAINERCAPACITY <br /> 1 Gallon <br /> l.. G CHEMICAL OR TRADE NAME DOT ID NO. DOT HAZARD CLASS CAS NO. <br /> PHYSICAL STATE I PHYSICAL STATE QUANTITY RELEASED ENVIRONMENTAL CONTAMINATION EXTENT OF <br /> STORED RELEASED RELEASE <br /> L <br /> CONTAINER DESCRIPTION CONTAINER TYPE LEVEL OF CONTAINS I <br /> CONTAINER MATERIAL CONTAINER CAPACITY <br /> MORE THAN 2 SUBSTANCES INVOLVED? ❑YES H NO <br /> ADDITIONAL INFORMATION <br /> H <br /> I I ::1 <br /> 1.A B C D 2. A B C D 3. A B C D 4. A B CD 5. A B C D 6. A BCD <br /> I SPECIAL <br /> STUDIES LOCAL STATE <br /> — _ — _ — — _ _ — — <br /> L <br /> HAZMAT IDENTIFICATION SOURCES HAZMAT CASUALTIES <br /> PERSONNEL REFERENCE MATERIAL #OF #OF #OF <br /> 60 Off-Site Non-Fire 98 o Reference DECONTAMINATED INJURIES FATALITIES <br /> J NRfRESPONDING N/A N/A N/A <br /> Services Material Used AGENCY PERSONNEL <br /> OTHERS N/A N/A N/A <br /> L I IVEHICLF MAKE/YEAR IVEHICLE LICENSE NO.ISTATE IVEHICLE ID NO. (VIN) I CA/DOT/PUC/ICC NO COMPANY NAME <br /> K I N/A I N/A N/A N/A I N/A N/A <br /> REPORTING OFFICER NAME/ID NO.(PRINT OR TYPE) DATE COMMENTS ATTACHED <br /> L <br /> R Lopez, OES7 5/21/2001 YES <br />