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'op4 '" o SAN JOAQUIN COUNTY- OFFICE OF EMERGENCY SERVICES <br /> '.o <br /> Q: <br /> HAZARDOUS MATERIALS DIVISION <br /> " 222 East Weber Avenue,Room 610, Stockton, CA 95202 <br /> �. Telephone (209)468-3969 <br /> .P <br /> ORN` <br /> ADDENDUM TO <br /> CALIFORNIA HAZARDOUS MATERIALS INCIDENT REPORT <br /> ` Date Incident Occured Time Incident Date At Scene Time At Scene SJOES Incident No. <br /> Dec. <br /> 8/22/2001 2120 XSJ-01396 <br /> M Initial Information Reported Wind Speed/Direction <br /> Received spill report from company representative-overfill of waste oil tank. <br /> Reporting Party Name Address Telephone No. <br /> George Russell 881 N. Shaw Rd (209)946-3704 <br /> Martin Brower Company Stockton, CA 95215 <br /> Responsible Party Name Address Telephone No. <br /> N Martin Brower Company 881 N. Shaw Rd (209)946-3704 <br /> Stockton, CA 95215 <br /> Responsible Party Representative Name Address Telephone No. <br /> George Russell 881 N.Shaw Rd (209)946 3704 <br /> Stockton. CA 95215 <br /> DES HazMat Team OES Personnel On Scene <br /> Activated <br /> NO No response <br /> Joint Team Activated? Date/Time Activated Members On Scene <br /> O NO <br /> Fire District Mitigation/Removal Actions <br /> 22 City of Stockton Company employees responded and cleaned up. <br /> Agency Notifications and/or Referrals <br /> Name of Agency Date of Notification Time of Notification Name of Representative <br /> Notified <br /> l� <br /> Reporting Officer Signature CHMIR Filed? Incident Type <br /> Q No Fixed Facility, Accident <br /> Page 2 <br />