Laserfiche WebLink
v 1.00 <br /> L <br /> SAN JOAQUIN COUNTY- OFFICE OF EMERGENCY SERVICES <br /> L HAZARDOUS MATERIALS DIVISION <br /> 222 East Weber Avenue,Room 610, Stockton, CA 95202 <br /> Telephone (209)468-3969 <br /> ADDENDUM TO <br /> CALIFORNIA HAZARDOUS MATERIALS INCIDENT REPORT <br /> Date Incident OccmedTime Incident Date At Scene Time At Scene SIDES Incident No. <br /> Occured <br /> 6/3/2000 1300 XSJ-01072 <br /> M 11nitial Information Reported Wind Speed/Direction <br /> Vehicle accident with diesel fuel spill <br /> Reporting Party Name Address Telephone No. <br /> Tim Hall 1818 S Fresno Street 209-937-8021 <br /> SFD Stockton, CA 95206 <br /> Responsible Party Name Address Telephone No. <br /> N Unknown <br /> Responsible Party Representative Name Address Telephone No. <br /> Unknown <br /> OES HazMat Team OES Personnel On Scene <br /> Activated <br /> NO No OES response requested <br /> - Joint Team Activated? Date/Time Activated Members On Scene <br /> Q NO <br /> Fire District Mitigation/Removal Actions <br /> SMUD will be notified. <br /> Agency Notifications and/or Referrals <br /> Name of Agency Date of Notification Time of Notification Name of Representative <br /> Notified <br /> Reporting Officer Signature CHMIR Filed? Incident Type <br /> Q No Mobile Vehicle Internal Fuel/Oil <br /> Page 2 <br />